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Blood in urine, fever. High RBC. Solution?

I noticed blood in my urine 3 months back. There was visible blood for 2 days and on the third day it subsided. I did not take a urine test then as I was taking medicines because of cold/mild fever . The same thing repeated a few days back (with cold/mild fever) and this time I did a routine urine test as well as culture and sensitivity test (no medicines were taken then). Everything was normal except for RBC in it (40-60 RBC/HPF). however, I took the urine sample for the test on the third when it had already subsided. I have no pain at all. There is one thing common in both the cases. Approximately after around 10 days I had my normal menstruation . Can you please throw me some light on this problem?
Asked On : Sat, 16 Mar 2013
Answers:  2 Views:  309
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General & Family Physician 's  Response
Hello and welcome to HCM.

Thank you for your query.

In my opinion, as you have gone about all the required initial investigations (i.e. a urinalysis, a urine culture, etc.), the best follow-up investigation now would be an abdominal and pelvic ultrasound.

Blood in the urine could be a problem relating to the renal system. Please go about the ultrasound for more clarity on your condition. 40-60 RBC/HPF is not normal at all and further evaluation will have to be conducted to rule out/diagnose all possiblities. Even more as you did not have your periods at that particular time.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
Answered: Thu, 21 Mar 2013
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Internal Medicine Specialist Dr. Maruti Karale's  Response
Thanks for writing to us.

RBCs of 40-60 indicates significant hematuria (blood in urine).This needs to be urgently evaluated and treated.

Following possibilities can be considered:
-Urinary tract infection
-Bladder stones
-Kidney stones or ureter stones
-Acute Glomerulonephritis
-IgA nephropathy ("Berger's disease")
-Alport syndrome
-Tumors and/or cancer in the urinary system, e.g.bladder cancer or renal cell carcinoma Kidney diseases
-Benign familial hematuria
-Paroxysmal nocturnal hemoglobinuria
-Tuberculosis of urinary tract or kidney.

I would like to suggest USG KUB,urine examination for proteinuria,casts,WBCs,Morphology of RBCs,CT scan of KUB ,and Nephrologist opinion for clinical correlation.

Hope this could help you.

Wish you good health.
Answered: Fri, 29 Mar 2013
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