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Need 2nd Opinion. What Could Be The Reason For High

Posted on Sun, 20 Jan 2019

Question: Need 2nd opinion.
What could be the reason for high levels of leukocyte esterase, erythrocytes and creatinine in urine?
Everyhing else in blood work is fine and normal levels but these three in urine level are high, I was given 5 days course of Nitrofuran 100 mg(dec 19)and retested again(Dec 31). leukocyte esterase dropped down from 500 to 25 but still in urine. Erythrocytes are still high.
Should i take more antibiotics or this looks a tumour or something serious?
Not many symptoms just a little pressure on left of pelvic area and back.

Follow up: Dr. Purva Patel (0 minute later)

Need 2nd opinion.
What could be the reason for high levels of leukocyte esterase, erythrocytes and creatinine in urine?
Everyhing else in blood work is fine and normal levels but these three in urine level are high, I was given 5 days course of Nitrofuran 100 mg(dec 19)and retested again(Dec 31). leukocyte esterase dropped down from 500 to 25 but still in urine. Erythrocytes are still high.
Should i take more antibiotics or this looks a tumour or something serious?
Not many symptoms just a little pressure on left of pelvic area and back.

Answered by Dr. Purva Patel (1 hour later)

Brief Answer:
possible calculus in the urinary system with suspected infection.

Detailed Answer:
Hello and welcome to 'Ask A Doctor' services.
I have read your query and here is my advise.

* As per my clinical experience, the raised levels of a leukocyte esterase, erythrocytes and
creatinine in urine indicates infection with gram-negative bacteria most likely.

* Considering the little pressure on the left of pelvic area and back, a persistence of
erythrocytes in urine; there can be possible gravels or calculus in the urinary system
associated with these or may be the primary cause of concern for the same.

* There is no possibility of a tumour to panic from this report.

* My suggestions at present:

- drink plenty of liquids.
- if there's any history of diabetes then keep your blood sugar under control.
- Keep genital hygiene at its best.
- Avoid intercourse at present (if sexually active)
- Please discuss the need for urine culture and ultrasound of the abdomen and pelvis
reports with your doctor ( which will figure out more details regarding the causative factor).

* I do not recommend further intake of antibiotics without specific culture report.

Hope this information will help you.
Let me know if I can assist you further.

Regards.

Dr Purva

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Purva Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Purva Patel (2 hours later)

Thank you Dr XXXXXXX My doctor ordered the culture after i completed the course of antibiotics, The results showed "no growth' (Dec 28th). The 2nd Urinalysis was performed on Dec 31. Which showed improvement in leukocyte esterase(from 500 to 25).
Today I have almost no pressure in pelvic region but I will see my doctor tomorrow and discuss the Urinalysis.

Follow up: Dr. Purva Patel (0 minute later)

Follow up: Dr. Purva Patel (37 minutes later)

My phone messed up the profile. I am Female 42(Healthy) I am expecting monthly periods in 3-4 days. I have attached the culture reports with blood work to this question.

Follow up: Dr. Purva Patel (0 minute later)

My phone messed up the profile. I am Female 42(Healthy) I am expecting monthly periods in 3-4 days. I have attached the culture reports with blood work to this question.

Answered by Dr. Purva Patel (14 hours later)

Brief Answer:
reports suggestive of better response to therapy.

Detailed Answer:
Hi XXXXXXX
Thanks for the attached reports.

There is significant improvement in the infection level.

I would recommend a further dose of antibiotic as per the guidance of your consultant to cure the infection completely.

Must continue to consume plenty of liquids for fast recovery.
Take care.

Above answer was peer-reviewed by : Dr. Nagamani Ng