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Had sinus infection and prescribed with amox clav. Recommended to have CBC and urine analysis. Is the bilirubin count normal?

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Posted on Wed, 13 Nov 2013
Question: I am alarmed by my recent blood results. I went to my doctor due to a sinus infection and was prescribed amox clav 750mg antibiotics. My doc also recommended labs including CBC and urine analysis which I did 2 days later. My total bilirubin was 1.3 mg/dL (lab XXXXXXX is 1.2) and my albumin was elevated at 5.3g/dL (lab XXXXXXX is 5.1). Other results: ALP - 54U/L, AST 22 U/L, ALT 20 U/L, Globulin 2.3 g/dL. CBC was within normal ranges for the lab. I am troubled by the bilirubin count though!!! My doctor didn't even mention the elevated levels of bilirubin and albumin so I wonder if it was missed? Since I requested a copy of the lab results, I was able to really take a deeper look and that's when I discovered the out of range levels.
doctor
Answered by Dr. Klerida Shehu (1 hour later)
Brief Answer:
Please refer to the following suggestions...

Detailed Answer:
Hi XXXXXXX

I have gone through your lab tests carefully, and I would recommend to try to calm down first. There is always a remedy for everything. Besides, I did not see anything alarming in your lab results.

Now, let me explain them one by one to you:

- Your total bilirubin resulted 0.1 point higher than normal range, which is not to be worried. Usually, we do not take into account such slightly high levels, especially, when there is not change in transaminases levels.

This is explained with the variations in the lab normal range (each lab has its own normal range, which can be within the acceptable range accepted by us, the doctors.

In addition, it might be related to a genetic "over-production" of bilirubin, which is very normal and you cannot do anything about it because won't give you troubles.

Another contributing factor is dehydration, which is caused by infection you are already treating.

- Your transaminases (alp, ast, alt) are within the normal range, so, this reinforces the fact that there is nothing to be worried about your liver function.

- With regards to your albumin level, dehydration might be a cause to such slight elevation and this is nothing to be worried about. If I could see any low level, then, I'd have to ask for further tests.

- With regards to your urine analysis and creatinine level, they all are related to infection of urinary tract. Please bare in mind that infections of upper respiratory tract are also associated with urinary tract infections which explains your urine test results.

Do not worry, the antibiotic you are taking will help resolve the both infections: sinus and of the urinary tract.

I would also recommend to drink more water, magnesium and potassium salts, and uva-mix tea.

- With regards to your total cholesterol and glucose levels, they are also slightly elevated, and no reason to be worried about.

At the end, the only test results that are to be taken into account are those related to your urine. However, I would recommend to repeat the urine analysis at the end of the treatment.

If I were your caring doctor, I would also suggest to repeat the bilirubin testing, but, this time to check for fractional bilirubin (direct, and indirect levels).

Hope it answered to your inquiry!

Dr.Klerida

p.s. If you other concern, please write back to me.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Klerida Shehu (1 hour later)
Thank you doctor. I am quite a worrier.

I will definitely start drinking more water. I run/jog 3 miles a day 6 days a week, so perhaps I am not drinking enough considering my physical exertion.

I am not scheduled to see my doctor again till December 20th, since he already saw my labs. Should I schedule a sooner appointment and ask for the tests you recommended or wait till the next scheduled appt? I finished my course of antibiotics yesterday.
doctor
Answered by Dr. Klerida Shehu (48 minutes later)
Brief Answer:
Suggested sooner appointment and lab tests...

Detailed Answer:
Hi XXXXXXX

Yes, definitely, if I were your caring doctor, I would like to have another lab exams after 2 weeks.

So, wait for other 14 days and then, take an appointment and run the above-mentioned tests. I want to add to do urine culture too to determine the right infection type and the right antibiotic.

So, to sum up, I suggest the following tests after 2 weeks:

- urine analysis

- urine culture

- creatinine (24 hours)

- bilirubin total + direct + indirect


Hope it answered to your inquiry! All the best!

Dr.Klerida

P.s. If you have further concern, do not hesitate to write me back!

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Klerida Shehu (22 hours later)
Ooops, didn't mean to close the session :( I suppose my final questions is regarding the fractional bilirubin measures. Considering that my other liver enzymes are ok, what will these fractional measures tell me?
doctor
Answered by Dr. Klerida Shehu (22 minutes later)
Brief Answer:
Please refer to the answer below...

Detailed Answer:
Hi XXXXXXX

Welcome back!

I have asked to measure the fractional bilirubin because we want to make sure what the real cause of elevated bilirubin is:

- blood problems (such as hemolysis due to infection, for which to take proper measures in time as you are already taking antibiotic)

- congenital hyperbilirubinemia (which is normal and not to be worried about)

Do not worry too much! Focus on treating your infection accordingly to improve the lab results.

Take care! Wish you health!

Dr.Klerida
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Klerida Shehu (18 hours later)
Thank you again for your help. I'll try to stop freaking out and, as you stated, focus on my infection for the time being.
doctor
Answered by Dr. Klerida Shehu (58 minutes later)
Brief Answer:
That is the wisest thing to do for the moment...

Detailed Answer:
Hi XXXXXXX

Welcome back!

That is the wisest thing to do. Time will show what to do next!

Wish you health!

Dr.Klerida
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2265 Questions

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Had sinus infection and prescribed with amox clav. Recommended to have CBC and urine analysis. Is the bilirubin count normal?

Brief Answer:
Please refer to the following suggestions...

Detailed Answer:
Hi XXXXXXX

I have gone through your lab tests carefully, and I would recommend to try to calm down first. There is always a remedy for everything. Besides, I did not see anything alarming in your lab results.

Now, let me explain them one by one to you:

- Your total bilirubin resulted 0.1 point higher than normal range, which is not to be worried. Usually, we do not take into account such slightly high levels, especially, when there is not change in transaminases levels.

This is explained with the variations in the lab normal range (each lab has its own normal range, which can be within the acceptable range accepted by us, the doctors.

In addition, it might be related to a genetic "over-production" of bilirubin, which is very normal and you cannot do anything about it because won't give you troubles.

Another contributing factor is dehydration, which is caused by infection you are already treating.

- Your transaminases (alp, ast, alt) are within the normal range, so, this reinforces the fact that there is nothing to be worried about your liver function.

- With regards to your albumin level, dehydration might be a cause to such slight elevation and this is nothing to be worried about. If I could see any low level, then, I'd have to ask for further tests.

- With regards to your urine analysis and creatinine level, they all are related to infection of urinary tract. Please bare in mind that infections of upper respiratory tract are also associated with urinary tract infections which explains your urine test results.

Do not worry, the antibiotic you are taking will help resolve the both infections: sinus and of the urinary tract.

I would also recommend to drink more water, magnesium and potassium salts, and uva-mix tea.

- With regards to your total cholesterol and glucose levels, they are also slightly elevated, and no reason to be worried about.

At the end, the only test results that are to be taken into account are those related to your urine. However, I would recommend to repeat the urine analysis at the end of the treatment.

If I were your caring doctor, I would also suggest to repeat the bilirubin testing, but, this time to check for fractional bilirubin (direct, and indirect levels).

Hope it answered to your inquiry!

Dr.Klerida

p.s. If you other concern, please write back to me.