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    What would elevated pus cells count in a urine test of an infant with fever mean?

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Posted on Thu, 30 May 2019 in General Health
Question: Hi Doctor

My Baby was getting a fever without any reason after taking urine report it was found that his PUS Cell was ranging from 12-15/hpf. After seeing this our ped suggested to take Urine Culture (was done without giving any medication) which showed up that his PUs Cell is now 4-5/ hpf and E.coli Colony Count is showing as 100000 CFU/ml.

What disease is he was suffering from? was it a UTI (which is now gone)
If Yes what could be the possible reason for the cause
Does it has an effect in long term (If yes how can we avoid it)
How we can get sure that he is now an infection free.

Baby Age : 1 Month 24 days
Current Medication Suggested: Zifi drops (1ml=25g)
doctor
Answered by Dr. Sumanth Amperayani 42 minutes later
Brief Answer:
This is definitely urinary tract infection - my suggestions are herewith

Detailed Answer:

Hi,

I am glad that you have uploaded the culture and sensitivity report. This is suggestive of urinary tract infection (UTI) and that too with a significant colony count.

Your pediatrician has suggested Zifi which is Cefixime. However, in the urine culture report, Cefixime is given under the resistant antibiotic which means it might not work for this particular organism.

Rather than that, I would prefer to use Amoxicillin-Clavulanate which is sensitive.

I would also like to get an ultrasound abdomen done to rule out ureteric reflux.

If you can get back to me with the exact current weight of the baby, then I would suggest you the correct dose of Amoxicillin- Clavulanate and duration also.

Coming to your queries one by one -

1. This is UTI and is under treatment. Whether it is gone completely or not we can decide after completion of antibiotic course and based on fever response.

2. Usually many times we will not be able to find out exactly the reason for UTI. One of the reasons might be washing the anal region from back to front after the baby passes stools.

3. Regarding the long-term outcome - this is the reason why I said I would like to get an ultrasound abdomen done. If there is a significant reflux, then we need to put the baby on daily low dose antibiotic to prevent further UTI and kidney scarring.

4. We can be 100% sure that the baby is infection free by repeating a urine culture after completion of the course of antibiotic.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Sumanth Amperayani
Pediatrician, Pulmonology
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sumanth Amperayani 20 minutes later
Weight is around 4.780

And Doctor Now my baby does not have fever now at all and he is active
doctor
Answered by Dr. Sumanth Amperayani 15 minutes later
Brief Answer:
Suggestions on first episode of urinary tract infection

Detailed Answer:

Hi,

You can give syrup Amoxicillin-Clavulanate of strength to 228 mg per 5 ml, at the dose of 1.5 ml twice a day for 7 days.

At the end of 7 days you can repeat a urine culture like what you have done now and get back to me with the report and I will guide you further.

Meanwhile, I suggest that you get an ultrasound abdomen done, so that you can get back to me with both the reports simultaneously.

I suggest you not to give Zifi as the organism is resistant to Cefixime.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Sumanth Amperayani
Pediatrician, Pulmonology
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 18 minutes later
Hi Doctor

Just a question for satisfaction

Is UTI common in babies or it is rare which he is suffering from
Hi Doctor

As Said we have taken a Sonography of KUB (as suggested by our ped) jus uploading the same . Can you please have a look at it.

Is there any major issues you see? (If Yes what could can we go ahead with, If not how much time will it take to recover)

Does Kidney, Uterus and Urinary Bladder are normal (if Not please suggest which part exactly has a problem and how can we avoid it.)

Reports have been attached
doctor
Answered by Dr. Sumanth Amperayani 14 hours later
Brief Answer:
This is a normal scan and no hydronephrosis - it is good

Detailed Answer:

Hi,

The USG report does not show any hydronephrosis or renal scarring. That is a very good news.

This is what you have to do:-
* Complete total 7 days of antibiotics.
* Repeat a urine culture after completion of the course.

While washing after the baby passes motion - make sure you wash the area from front to back and not from back to front.

Hope I have answered your query. I will be glad to have any further queries you have.

Regards,
Dr. Sumanth Amperayani
Pediatrician, Pulmonology
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 23 hours later
Hi Doctor,

Today I observed that while peeing my babies genital gets swollen(just like ballooning) , when he is done with his pee the genital goes back normal and when i touch his genital the muscle seems to be a bit hard.

Is It normal?
Is It related to UTI?
If, not UTI related ,what it is?
doctor
Answered by Dr. Sumanth Amperayani 7 minutes later
Brief Answer:
This is normal for such a young baby - don't worry

Detailed Answer:

Hi,

This is normal for such a young baby, don't worry.

If the ballooning of the produce is still persisting even after 3-6 months of age, then we can use an ointment for loosening the foreskin and decrease the tightness of the prepuce or foreskin of the penis. But right now you need not worry.

This is not related to urinary tract infection.

The hardness which you are feeling after urination is also normal. Do not worry about that too.

Hope I have answered your query.

Regards,
Dr. Sumanth Amperayani
Pediatrician, Pulmonology
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8257 Questions

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