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Suffer Cellulitis And Urinary Tract Infection? Suggestions?

Posted on Mon, 23 Sep 2013

Question: Cellulitis and uti

Answered by Dr. Shanthi E (1 hour later)

Brief Answer:
Need more information

Detailed Answer:
Hi,

It seems like you have a dual condition consisting of both Cellulitis and UTI. Are you diabetic?

Keflex is an effective antibiotic against Cellulitis. Please complete the course of it. However, the ideal way to treat Cellulitis is to take a swab tissue and culture from the affected area. In case of UTI, urine culture needs to be done.

Based on both the reports, we could match the antibiotic sensitivity in you and treat you with the right antibiotic. This is the usual practice.

Please write in detail about the duration of these 2 conditions, associated symptoms, investigations performed, and treatment taken until now.

Awaiting your response.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (15 minutes later)

Thanks for responding. I have taken 40 the whole prescription of keflex and now i am on cephlaxin for uti. Been on that antibiotic since fri. Foot is ok but i am lying with an icepack because of my uti. My doc did no blood work. I have a moderate amt. of ketonesvin my urine.

Answered by Dr. Shanthi E (1 hour later)

Brief Answer:
Are you diabetic?

Detailed Answer:
Hi,

I am sorry; you did not answer my query - Are you diabetic? I am strongly suspecting Diabetes in you as you have multiple infections at the same time.

Please get a random blood sugar test done if not done earlier. Ketones in urine are also pointing towards Diabetes. Are there sugars in urine too?

Ideally speaking, you must take intravenous (IV) antibiotics after taking a blood sample for culture and sensitivity testing. The antibiotic may be changed according to the blood culture report on a later date.

Please rule out Diabetes first. If possible, get yourself hospitalized and get started on IV antibiotics at the earliest.

I think this is not 'wait and watch' situation. Please go ahead accordingly.

Get well soon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (37 minutes later)

Wow the doc did not even do bloodwork i am not a diabetic but my mgm was. The ketones were in my urine & i have a yeast infection.

Answered by Dr. Shanthi E (17 hours later)

Brief Answer:
Please get a random blood sugar test done

Detailed Answer:
Hi,

Request your treating doctor to do a blood routine test along with random blood sugar test.

Yeast infection also occurs quite often in Diabetes. Hope you are treated with anti-fungal medicines for the yeast infection.

Follow my earlier suggestions.

Once again, I wish you quick recovery.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (10 minutes later)

Thank you so much. That is the answer i expected!!!!

Answered by Dr. Shanthi E (1 hour later)

Brief Answer:
Pleasure is mine, anytime

Detailed Answer:
Take care!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (37 hours later)

I am VERY CONERNED. Went to doc. Elevated wbc, protein, and ketones in urine. Weight loss , high creatine levels profuse excessive sweating, extreme fatigue, dizzy. I have taken keflex, septra and now septra. Still high wbc and high creatinie. My doc said drink plenty of water... I suggestedviv fluids. Why so many infections and no response to antibotics. I am worried about diabetes mellitus, shock, or sepsis. It started with cellulitis, then coughing, then uti that progressed to kidney infection. I have severe sweating and so so so tired. Body temp 95-96, blood sugar is jumping fro 70 to 120. I have lost 20 pounds in 2 months. Very high wmc count! What do you think is going in? He said drink 8 oz of water every hour, and contiue with antibotics and probiotics and repeat bw in 1 mth. Should i go to hospital?? I am so scared!!!

Answered by Dr. Shanthi E (11 hours later)

Brief Answer:
Go to the hospital

Detailed Answer:
Hi,

Yes, your problem is concerning and it is making me think deeper.

Here are my suggestions:

- Please stop all the antibiotics cold XXXXXXX
- Please, and please do get a FBS (Fasting Blood Sugar) and PPBS (Post Prandial Blood Sugar) test done. We need to definitely rule out Diabetes Mellitus in you, as a first priority.
- If possible, change your doctor. Get to another skilled and experienced urine analysis and complete blood count after 2 days and not after a month.

I am sorry; but you are in a concerning situation and need to be managed effectively and rightly.

Let me know if I could help you further.

Get well soon.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shanthi E (2 days later)

Hi
I went to ER yesterday with severe chest pain. They said I hyperventilated with a panic attack. I thought it was pneumonia but they said chest X-ray was normal. They said sugar was normal. But I went from not being able to urinate too all the time. My mouth was dry everything smelled fruity and I had a metal taste in my mouth so I am still concerned. Still tired with some tighting of the chest. Very hungry!! Weird.

Answered by Dr. Shanthi E (32 hours later)

Brief Answer:
Get your HbA1C test done

Detailed Answer:
Hi,

I am sorry you had to go to the ER.

I am glad your sugar was normal. However, to check your sugar status over the past 6 months, we do a test called HbA1C. Please get this done. It would be helpful to assess your sugar levels in the past.

Could you please upload some of the relevant investigations that was done in you? Mostly, the biochemistry labs including your electrolytes. Also, upload the urine analysis report. You have a feature to upload the reports by yourself on the right side of this query page. You may utilize it. Is there ketones in blood as well?

I am sorry; your concerns are little complicated to come to any conclusion.

Hope we find a solution to it sooner. Sorry for my delayed response.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (44 minutes later)

Yes there is still a small count of ketones in my urine. I do not have a copy of the bloodwork yet.

Answered by Dr. Shanthi E (1 hour later)

Brief Answer:
reason for ketones in urine

Detailed Answer:
Hi,

Did you ask any of your treating doctors the reason for ketones in urine? I would be more interested to know about it. My only concern is the ketones in urine and your blood sugars being normal. This is a conflicting picture. It cannot be this way. Or, you have starved completely for last few days to get ketones in your urine.

Having ketones in urine is definitely abnormal. The cause need to be investigated and treated accordingly for the benefit of the patient.

Hope you are understanding what I am trying to convey to you.

My wish is you be healthy all the time.

Take care!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (38 hours later)

Hello again,
I tried to upload my reports. My main conern is elevated wbc 11.4, absolute EOS, 1.10, creatinine, 1.24, and GFR, 49. These values do not seem to correlate. Symptoms, very tired, thirsty, irratible, and some memory loss which may be related to stress. Still a small amount of ketones in urine. I feel the doctors think I am overreacting bit I do not feel well. What do you suggest of this lab report? I am very thankful for your input on this. Please respond as quickly as possible for I am very concerned.
Thanks XXXXX

Answered by Dr. Shanthi E (8 hours later)

Brief Answer:
The reports are not clinically significant

Detailed Answer:
Hi XXXXXXX

I am sorry for my delayed response.

I have seen the uploaded reports. The values which you have mentioned in the follow up query are all slightly deranged. They are not significant clinically, meaning to say these to not have serious implications on your body functioning.

Ok, let us listen to your doctors for a while. Wait and watch over your symptoms for a week and let me know how you feel then. I shall suggest you accordingly.

Take good care of yourself.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (17 minutes later)

I am not sure what you mean deranged? I know it seems odd for glucose to be normal and ketones be in urine. I was scared to tell you but I have been smoking an illegal substance. I am scared my metabolic state is some sort of toxins or acidosis problem. If not thank God but I can not ask my Doctors this info. Hope you understand!! If clinically this still doesn't make sense then my mind will be at ease.
Thanks for your time!!

Answered by Dr. Shanthi E (1 hour later)

Brief Answer:
Put your mind at ease

Detailed Answer:
Thanks for writing back XXXXXXX

Now, the picture is crystal clear to me. You are right. It is perhaps the substance abuse induced keto-acidosis. This is definitely possible in your case.

I am glad you wrote back to me. Yes, your body's metabolic state seems to be disturbed by this illegal substance. Please try and stop its use at the earliest.

What I mean by deranged is that the values are slightly above the normal limits. There are no serious effects on kidneys due to this. If you stop this now, and drink plenty of fluids orally, things will settle back to normal quickly. I hope you are able to understand me.

Yes, for now these values do not make much sense clinically. Hence, you can put your mind at ease and relax a bit.

Take care of yourself and stay motivated.

Regards,

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar