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Having Fever And Chills, Feeling Weakness And Slight Headache. Urine Test Done. What Does The Report Suggest?

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Posted on Mon, 5 Nov 2012
Question: Hi my husband has been having fever since several days and chill in the night sometimes. He has extreme weakness and a slight headache. The doctor has asked us to run the following tests:

1) Aerobic C&S blood
2) Haemogram
3) Peripheral Smear for Malarial Parasite
4) Abdomen Ultrasound
5) Urine Routine and Microscopy
6) Widal Test

His urine routine and microscopy tests show Epithelial Cells 4-6 Hpf Pus Cells 3-4 Hpf what does this mean?
doctor
Answered by Dr. Hema Yadav (2 hours later)
Hello,
Thanks for posting your query.
The presence of pus cells and increased epithelial cells in urine is suggestive of a urinary tract infection( UTI ).
According to the information you have provided the two most probable causes for fever with chills are malaria and UTI .
So considering all his reports which are normal except the urine routine it does seem that your husband is most likely suffering from a minor or early urinary tract infection.
The treatment for the same is a course of antibiotics ( fluroquinolones or depending on culture report) along with other supportive therapy like antipyretic analgesics ( paracetamol , multivitamin supplements etc.
The next best step would be to get a urine culture & antibiotic sensitivity test before starting an empiric antibiotic . The result may take three days but that will ensure the exact cause of the infection and the best antibiotic to eradicate it.
Your doctor can order the test and start him on treatment simultaneously.
Meanwhile he should drink plenty of water for a faster recovery.
Please don't worry as his symptoms are likely to completely resolve within a week of starting the appropriate treatment
Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Wishing him a speedy recovery.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hema Yadav (18 hours later)
The Widal report is as follows:

S typhi

TO Positive 1:160 Titer

TH Negative

AH Negative

BH Negative

The doctor says it could be Typhoid. For which he has prescribed

1) TOPCEF CLAV 200
2) Dolo-650

Could you also tell what kind of diet to follow for this?
doctor
Answered by Dr. Hema Yadav (4 hours later)
Hello,
Thanks for the follow up.
Yes though the report is not confirmatory there is a possibility of this being a salmonella (typhoid ) infection .
The treatment started is appropriate .
Kindly note the following dietary restrictions for typhoid patients.
1. Give him plenty of water and other fluids ( ORS, juices , soups etc)
2. Give him a soft digestible diet khiccdi , vegetable with rice dal , idli etc
3.Gradually start a well-balanced diet.Avoid foods which derange and upset the
stomach. Avoid spicy food, tea, coffee, aerated drinks, refined foods and alcohol.
4.Oral multivitamin and zinc supplement (like zincovit or Becosules etc ) once daily might help in recovery
Bed rest and adequate sleep are essential .

Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Wishing him good health.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Hema Yadav

Pediatrician, Infectious Diseases

Practicing since :2005

Answered : 1528 Questions

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Having Fever And Chills, Feeling Weakness And Slight Headache. Urine Test Done. What Does The Report Suggest?

Hello,
Thanks for posting your query.
The presence of pus cells and increased epithelial cells in urine is suggestive of a urinary tract infection( UTI ).
According to the information you have provided the two most probable causes for fever with chills are malaria and UTI .
So considering all his reports which are normal except the urine routine it does seem that your husband is most likely suffering from a minor or early urinary tract infection.
The treatment for the same is a course of antibiotics ( fluroquinolones or depending on culture report) along with other supportive therapy like antipyretic analgesics ( paracetamol , multivitamin supplements etc.
The next best step would be to get a urine culture & antibiotic sensitivity test before starting an empiric antibiotic . The result may take three days but that will ensure the exact cause of the infection and the best antibiotic to eradicate it.
Your doctor can order the test and start him on treatment simultaneously.
Meanwhile he should drink plenty of water for a faster recovery.
Please don't worry as his symptoms are likely to completely resolve within a week of starting the appropriate treatment
Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Wishing him a speedy recovery.
Regards