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Suffering from recurring pus cells in the urine. History of angioplasty and diabetes. Permanent cure?

My wife has been suffering from recurring pus cells for the last many years now.She is 55 years and uncontrolled diabetic (20 years).Undergone angioplasty two years back. For the last one month now she is having FULL FIELD pus cells. Was give OFLOX-400 twice a day for 7 days. Then Urine culture was done and IV NETILICIN was administered but very little relief.Please suggest
Asked On : Wed, 27 Mar 2013
Answers:  2 Views:  65
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General & Family Physician 's  Response
Although patients with diabetes are more prone to heart attacks, stroke, and peripheral vascular disease, as well as damage to the eyes, nerves, and kidney,but  there is another common complication of diabetes that gets less attention is urinary tract infection.

Women with diabetes are about two to three times more likely to have bacteria in their bladders than women without diabetes (interestingly, the same does not appear to be true for men). There also seems to be an increased risk of the infection spreading upwards into the kidneys in diabetic patients, and diabetic women with urinary tract infections are also more likely to require hospitalization than non-diabetic women.
This occurs because of....
....Poor circulation in diabetes reduces the ability of infection-fighting white blood cells to get where they need to go.
.....Many people with diabetes also have dysfunctional bladders that contract poorly; this allows urine to remain in static pools for long periods of time, providing luxurious ponds for bacteria to grow in.
.....Increased concentration of glucose in urine decreases its anti-bacterial activity and increases the chances of bacterial growth.
.....Prolonged hyperglycemia results in increased adherence of disease causing microbes(E-coli )to uroepithelial cells.

Strict control of blood sugar levels.
Prolonged course of anti biotics after a proper culture and sensitivity
Treatment of any precipitating cause like some calculus.
Plenty of oral liquids
Control of blood pressure 
Management of condition jointly by diabetologist and a nephrologist.

Answered: Wed, 27 Mar 2013
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General & Family Physician Dr. Shoaib Khan's  Response
Hello and welcome to HCM.

Thank you for your query.

The best options you have right now are to first follow the result of the urine culture examination and use the most susceptible antibiotic to treat the urinary tract infection (UTI) which is causing the pus cells in the urine.

As she is a diabetic, the next most effective method would be to adequately control her blood sugar levels. Diabetics are more susceptible to infections due to the high blood sugar levels which weaken the immune system defenses and thus cause either resistant, recurrent or persistent infections.

Thus, you will have to achieve better control of her blood sugar levels. If she is only on oral hypoglycemic agents currently, then you might have to discuss the possibility of introducing insulin to her regimen. This will surely help, if well monitored and adequately prescribed.

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, 28 Mar 2013
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