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Had fever. No cough or pain. Had UTI. Took OTC Azo test showed positive on leukocytes and negative on nitrites

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Internal Medicine Specialist
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I have had a low grade fever for going on two weeks now--99.3-100.6. Very tired all the time. No other outward symptoms such as cough or pain. Clear drainage from seasonal allergies. I've had several UTIs this year and am not having any signs of one now. But just as a precaution I took one of the OTC Azo test with slight positive on leukocytes and negative on nitrites. I'm considering going to my nurse practitioner but not really sure she can do anything for me--maybe urinalysis and CBC. I'm 41 with no major medical issues.
Posted Wed, 23 Oct 2013 in Medicines and Side Effects
Answered by Dr. Rakesh Karanwal 1 hour later
Brief Answer:
Low grade fever

Detailed Answer:

Good morning to you.

I am Dr.(Col) R Karanwal, M.D. (Internal Medicine) at your assistance.

I can fully appreciate the pain and agony that you are passing through and thereby, take this opportunity to fully address to your query.

From the details provided, it is apparent that you have several allergic problems. Elaboration of the same would definitely have been helpful to me.

In view of recurrent UTI infections, it is possible that either the treatment was not given for adequate period/dose; further, possibility of concurrent conditions, such as diabetes needs to be evaluated.

In this context, persisting low-grade fever indicates that either you have an ongoing UTI, maybe due to fungal infection; possible presence of a kidney/urinary bladder stone or a growth; infection in the pelvic region, indolent sinusitis; silent fungal infection of the lungs, to name a few .

Given the information at my disposal, my plan of action would therefore be:-

1. Get a urine culture done for both bacteria and fungi, along with culture of the same, to know the antibiotics which the culprit organisms are most sensitive to.

2. An ultrasound of abdomen to exclude/confirm kidney or urinary bladder stone/growth, inflammation of the pelvic region including uterus.

3. Chest X-ray to see for evidence of fungal lesion, if any.

4. Blood sugar tests to exclude diabetes.

5. Finally, necessary tests to exclude a condition called Systemic Lupus Erythematosus (SLE), as your problems can be a manifestation of this condition.

I will therefore recommend that you consult your doctor, who will order for all the investigations listed above and, pending investigation results, start with an empirical course of suitable antibiotics.

This notwithstanding, I would request you to kindly revert back to me with the following information in great detail :-

1. The types/nature of allergies
2. Any lesions, patches over the body?
3. Presence of chronic sinus problem or breathing problem
4. Vaginal discharge, in any, and its odor + color; are periods regular/irregular.

I am looking forward to the requested information in detail.

Wish you a speedy recovery and good health.

Fond regards and best wishes,

Dr. (Col) R Karanwal
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