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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Got Over Malaria. ESR Abnormal, Urine Infection And Pus Cells. Boils, Joint And Muscle Pain. Rheumatic Arthritis?

I am worried and need some help. I am a 20 years old female. My doctor seems to be confused. It all started when I got over malaria about a year and a half back and did my blood tests to see if everything was normal. My ESR was 90 and there were pus cells and blood and some infection in my urine. I also had pain in my body, in the joints and muscles and got boils all over my legs. My doc gave me some medicines and I got fine but the ESR remained high, 90. I ignored it coz i was feeling good physically and didn t seem to have any problem. But since then, every few months I would get the attack of the boils and joint and muscle pain. My doc asked me to test for rheumatic arthritis but the reports came negative and also the x-rays were normal. My boils are not returning but I still have the joint and body ache every day along with low grade fever. My fasting glucose is also a lil high, 114. Below is the summary of my latest reports.. WBC 12,600 HIGH... ref range:4000 - 0000 platelets on smear: increased peripheral smear: leucocytosis, mild hypochromia platelets: 6,67,000 HIGH Ref range: 0000 - 0000 ESR 100 fasting blood sugar 114 fasting uring glucose NIL ================= examination of urine: Red blood cells 4-6/HPF pus cells: 30-35 HPF E coli detected.. count: 35,000 =============== small cyst in my right ovary measuring 3.8x2.7x2.3cm liver is normal gall bladder is normal urinary bladder is normal uterus normal pancreas normal spleen normal chest x ray normal ============= HLA b 27 negative anti nuclear antibody negative Hba1c 6.5 RA quantititive serum 13.7 anti CCP 0.9 Knee xray normal wrist x ray normal pelvis xray normal. Please help me!! I am so lost. :(
Tue, 6 May 2014
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Orthopaedic Surgeon 's  Response
It seems that you are having Urinary Tract Infection. So better you take antibiotics. As history is long so Urine culture is required. Its never rheumatoid artheritis because its crteria is diffrent and you are not having Morning Stiffness.
After urine culture you should take Antibiotics according to senstivity. If you are already taking some antibiotics then Urine culture may be sterile. Sotake Broad Spectrum Antibiotics Like Third Generation Cephalosporins like tab Ceftum 500mg BD X 3 Days. And Tab Linzolid 600mg BD x 3 Days.
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Got Over Malaria. ESR Abnormal, Urine Infection And Pus Cells. Boils, Joint And Muscle Pain. Rheumatic Arthritis?

It seems that you are having Urinary Tract Infection. So better you take antibiotics. As history is long so Urine culture is required. Its never rheumatoid artheritis because its crteria is diffrent and you are not having Morning Stiffness. After urine culture you should take Antibiotics according to senstivity. If you are already taking some antibiotics then Urine culture may be sterile. Sotake Broad Spectrum Antibiotics Like Third Generation Cephalosporins like tab Ceftum 500mg BD X 3 Days. And Tab Linzolid 600mg BD x 3 Days.