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Suggest Treatment For Chronic Urinary Infection
Question: Hello,
So let me start from the beginning as there are many factors to this. My father is quadrapalegic and has been for about 30 years. He's 69. He's been dealing with chronic UTI's for years and years. It got to the point where he's built up a resistance to all the oral anti-biotics so 3 months ago he had a cestectomy/ urinary diversion and an ileal conduit. After a month post op he went back to work. He's a radiologist so he doesn't move around too much. His energy is still very low and he seems to feel more washed out as time goes on. He feels like he's getting sick but his temp and blood pressure are always normal. We've been told to not worry unless his temp goes over 101. It just makes us uncomfortable cutting it that close. Is there any other ways to determine if he should go to the hospital to get tested for infection? His urine has had a strong smell to it and a little mucus ever since the surgery and we were told thats normal. It's also been murky since the surgery. We just don't want to be in a serious situation where he needs help asap but didn't act fast enough. So my question is: What are signs of a UTI we should be looking out for?
So let me start from the beginning as there are many factors to this. My father is quadrapalegic and has been for about 30 years. He's 69. He's been dealing with chronic UTI's for years and years. It got to the point where he's built up a resistance to all the oral anti-biotics so 3 months ago he had a cestectomy/ urinary diversion and an ileal conduit. After a month post op he went back to work. He's a radiologist so he doesn't move around too much. His energy is still very low and he seems to feel more washed out as time goes on. He feels like he's getting sick but his temp and blood pressure are always normal. We've been told to not worry unless his temp goes over 101. It just makes us uncomfortable cutting it that close. Is there any other ways to determine if he should go to the hospital to get tested for infection? His urine has had a strong smell to it and a little mucus ever since the surgery and we were told thats normal. It's also been murky since the surgery. We just don't want to be in a serious situation where he needs help asap but didn't act fast enough. So my question is: What are signs of a UTI we should be looking out for?
Brief Answer:
Read detail answer below
Detailed Answer:
Hello
Hello
Thanks for your query ,based on the facts that you have posted I would recapitulate the entire story as under ,
Your 69 years old father who is quadriplegic since 30 years had repeated episode of UTI which became resistant to almost all antibiotics making it mandatory to take decision of doing surgery of Cystectomy with Ileal conduit urinary diversion which was done 3 months back .He has recovered satisfactorily and resumed his work as a Radiologist although he has symptoms like general weakness and malaise etc .
As regards Generalized weakness and malaise he has I would state that these symptoms are bound to be there due to long standing infection and side effects of multiple antibiotics that were being pumped in his body.It will take months together to wane away these side effects .
As regards his smelling urine and presence of mucus in the urine.it is due to natural secretions of salts and mucus from the conduit and takes 12-18 months to get minimized gradually.
As regards chances of getting infection I would say since mucus is a good medium for bacterial growth and ureter being kept wide open (Spatulated ) before being anatomized to intestine (Conduit ) there is reflux of urine from conduit into ureters and in to kidney with risk of retrograde infection setting up in the kidney (Pyelonephrits)
In view of all these known and anticipated complications one has to be vigilant and keep watch for following predomal signs and symptoms of urinary infection
1) High grade fever with Rigors
2) Flue like symptoms
3) Nausea and vomiting
4) Cloudy urine with offensive smell and blood in urine (Hematuria)
5) Sweating
6) Pain in Renal area
As a precaution I always advise my patients since last 40 years of my practice to observe following measures to be followed religiously
1) Drink adequate water 3-4 liters per day
2) Since bacteria do not grow in acidic medium ;try to keep urine acidic ,This can be achieved by giving Barley water 300-400 ml and Vit c 1-2 grams every day
3) Give multi Vitamins and fruits to improve general resistance
4) Get routine urine tests done every 15 days to detect presence of pus cells and leukocyte esterase in urine
5) Get urine culture done every 4-6 weeks (Irrespective of signs of infection) and give appropriate antibiotics if required
With these measures most of the patients get encouraging results and satisfactory recovery .
Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.
Read detail answer below
Detailed Answer:
Hello
Hello
Thanks for your query ,based on the facts that you have posted I would recapitulate the entire story as under ,
Your 69 years old father who is quadriplegic since 30 years had repeated episode of UTI which became resistant to almost all antibiotics making it mandatory to take decision of doing surgery of Cystectomy with Ileal conduit urinary diversion which was done 3 months back .He has recovered satisfactorily and resumed his work as a Radiologist although he has symptoms like general weakness and malaise etc .
As regards Generalized weakness and malaise he has I would state that these symptoms are bound to be there due to long standing infection and side effects of multiple antibiotics that were being pumped in his body.It will take months together to wane away these side effects .
As regards his smelling urine and presence of mucus in the urine.it is due to natural secretions of salts and mucus from the conduit and takes 12-18 months to get minimized gradually.
As regards chances of getting infection I would say since mucus is a good medium for bacterial growth and ureter being kept wide open (Spatulated ) before being anatomized to intestine (Conduit ) there is reflux of urine from conduit into ureters and in to kidney with risk of retrograde infection setting up in the kidney (Pyelonephrits)
In view of all these known and anticipated complications one has to be vigilant and keep watch for following predomal signs and symptoms of urinary infection
1) High grade fever with Rigors
2) Flue like symptoms
3) Nausea and vomiting
4) Cloudy urine with offensive smell and blood in urine (Hematuria)
5) Sweating
6) Pain in Renal area
As a precaution I always advise my patients since last 40 years of my practice to observe following measures to be followed religiously
1) Drink adequate water 3-4 liters per day
2) Since bacteria do not grow in acidic medium ;try to keep urine acidic ,This can be achieved by giving Barley water 300-400 ml and Vit c 1-2 grams every day
3) Give multi Vitamins and fruits to improve general resistance
4) Get routine urine tests done every 15 days to detect presence of pus cells and leukocyte esterase in urine
5) Get urine culture done every 4-6 weeks (Irrespective of signs of infection) and give appropriate antibiotics if required
With these measures most of the patients get encouraging results and satisfactory recovery .
Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I have some follow up questions.
Since the site of the chronic infection was removed, will he still be resistant to the oral antibiotics?
Does the smell of urine get noticeably worse when there's a UTI? It already always smells.
How serious is a UTI once he gets a high fever?
Obviously I know we should go to the ER but I have a fear that by the time he gets there and had urinalysis and everything done it may be too late and
Since the site of the chronic infection was removed, will he still be resistant to the oral antibiotics?
Does the smell of urine get noticeably worse when there's a UTI? It already always smells.
How serious is a UTI once he gets a high fever?
Obviously I know we should go to the ER but I have a fear that by the time he gets there and had urinalysis and everything done it may be too late and
Brief Answer:
Bacteria always change their sensitivity pattern.
Detailed Answer:
Hello
Thanks for query .
Once the infections sets any where in the body b there is frequent change in sensitivity pattern of bacteria so they may become resistant to antibiotic to which they were sensitive in past .This is the reason we have to do urine culture frequently.
Urine smell becomes offensive if infection sets in again.
Fever is one of the symptoms of UTI and it can not be considered as serios .
UTI is never so fatal that one will succumb by the time patient goes to hospital .
Thanks and Regards.
Dr.Patil.
.
Bacteria always change their sensitivity pattern.
Detailed Answer:
Hello
Thanks for query .
Once the infections sets any where in the body b there is frequent change in sensitivity pattern of bacteria so they may become resistant to antibiotic to which they were sensitive in past .This is the reason we have to do urine culture frequently.
Urine smell becomes offensive if infection sets in again.
Fever is one of the symptoms of UTI and it can not be considered as serios .
UTI is never so fatal that one will succumb by the time patient goes to hospital .
Thanks and Regards.
Dr.Patil.
.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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