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Suggest Treatment For Persistent Urinary Tract Infection In A Diabetic

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Posted on Mon, 19 Oct 2015
Question: Last time i consulted u and sant u some pics of genitals and u recommended metrogyk, ceflixine and Probiotic alongwith povidone iodine for 7 days. I got relief instantly but the problem is not 100 percent solve. Infact after 15 days of finishing medIcatiob it has started increasing. Itching is somewhat less (excessive itching only in night). I m still applying povidone iodine regularly twice daily. But burning sensation sp3cially while urinating and before urinating is the main problem. Should i repeat the same medication or increase the dose. My diabetes is under control. Last time while taking medicine i felt heavy acidity.
doctor
Answered by Dr. T Chandrakant (37 minutes later)
Brief Answer:
may be urinary tract infection, Urethritis.

Detailed Answer:
Hi.
Thanks dear friend for your query and feedback.
You last question was on 13 August 2015, wherein the problem was discussed in details including the hot and humid atmosphere you work in, your symptoms wrinkles and redness on tip of the penis, excessive itching in genitals, burning sensation on tip of penis, testicles feeling like heavy, allergy in genitals since 3 years but ignored it, not sexually active, diabetes under treatment and taking Cefixine, Metronidazole, Velgut and povidone iodine locally. You had acidity that time.
If there was instant relief, although not 100%, we have to think about the possible causes again. Itching is less, only at night, burning sensation while urinating and *before urinating is the main problem.
Diabetes is under control, wants to know whether to continue the same medicines...

By taking into consideration the past history, medications you have taken and the present complaints I would advise you the following:

Please go for the following tests:
-Blood: CBC, blood sugar fasting and postpradial, HbA1c for sugar control, urea, creatinine,
- Urine- Routine, microscopy, culture and sensitivity (sample to be given in sterile container before you start antibiotics). This will get you you the better results and if infection is detected this report will help for the most suitable antibiotic also.
- Ultrasonography of the abdomen particularly for genitourinary system, this being important as you have symptoms pertaining of urination.
- Consult a local Doctor, get the genitalia and the scrotum examined for the condition of the skin, whether there are any lesions like scabies (as the itching is more during night) and please send absolutely clear pictures.

Once the samples are sent for all the tests, you may start taking Cefixime and also take Omeprazole if acidity is developed.
Please apply ''Liquid'' povidone iodine locally, only once and no ointments please.
As discussed previously, it is important to have the cleaning with tap water at least twice daily may be with mild soap (soap should not be retained and plenty of water needed to clean the area, tap dry with cotton cloth or hair-dryer) Washing of the irritants due to hot and humid atmosphere helps a lot.

Since your main symptoms are related to urination as you have mentioned in your present query, I think you may have urethritis and urinary tract infection.

I hope this answer helps you for proper diagnosis and proper treatment.
Please give feedback, the reports and the clear pictures.
Please feel free to ask if you feel that there is a gap of communication.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (22 hours later)
what i read about scabies on the internet,i doubt having scabies. also there is much relief since i took last medication. skin is much better. i will go for urine test. but i feel ur diagnose earlier was correct. i m attaching images. can u suggest something for imeediate relief.
doctor
Answered by Dr. T Chandrakant (44 minutes later)
Brief Answer:
plenty of water orally

Detailed Answer:
Thanks for your feedback and clear pictures.
The scrotal skin and the the glans look near normal. Far more improved.

There is no scabies in the pictures seen.

Take plenty of water for the urine to be diluted, give the samples and start the treatment as suggested above.

Take antibiotic for 14 days for probable cure.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. T Chandrakant (2 hours later)
thank u 4 ur feedback. the skin is improves but not 100 percent cured. should i take mwtrogyl again for sometime combined with cefizime. i am sensing 1 more picture of lower part of penis skin for better idea.
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Please send a fresh picture.

Detailed Answer:
Please send another picture as the recent one is out of focus.
Since you had developed acidity last time, it might have been due to Metronidazole, hence I avoided.
Try Metronidazole in 200 mg thrice daily dose and if acidity is developed you may please discontinue.
The skin looks near normal. The changes are due to the effect of too much sweat and hence the need to clean it regularly.
Use liquid povidone iodine- not the ointment.

I hope this helps you.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. T Chandrakant (27 minutes later)
should i take same antibiotic for 14 days
doctor
Answered by Dr. T Chandrakant (6 minutes later)
Brief Answer:
Yes

Detailed Answer:
Another picture too is out of focus.
Cefixime for 14 days that is 2 weeks. Reasons discussed above already.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19778 Questions

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Suggest Treatment For Persistent Urinary Tract Infection In A Diabetic

Brief Answer: may be urinary tract infection, Urethritis. Detailed Answer: Hi. Thanks dear friend for your query and feedback. You last question was on 13 August 2015, wherein the problem was discussed in details including the hot and humid atmosphere you work in, your symptoms wrinkles and redness on tip of the penis, excessive itching in genitals, burning sensation on tip of penis, testicles feeling like heavy, allergy in genitals since 3 years but ignored it, not sexually active, diabetes under treatment and taking Cefixine, Metronidazole, Velgut and povidone iodine locally. You had acidity that time. If there was instant relief, although not 100%, we have to think about the possible causes again. Itching is less, only at night, burning sensation while urinating and *before urinating is the main problem. Diabetes is under control, wants to know whether to continue the same medicines... By taking into consideration the past history, medications you have taken and the present complaints I would advise you the following: Please go for the following tests: -Blood: CBC, blood sugar fasting and postpradial, HbA1c for sugar control, urea, creatinine, - Urine- Routine, microscopy, culture and sensitivity (sample to be given in sterile container before you start antibiotics). This will get you you the better results and if infection is detected this report will help for the most suitable antibiotic also. - Ultrasonography of the abdomen particularly for genitourinary system, this being important as you have symptoms pertaining of urination. - Consult a local Doctor, get the genitalia and the scrotum examined for the condition of the skin, whether there are any lesions like scabies (as the itching is more during night) and please send absolutely clear pictures. Once the samples are sent for all the tests, you may start taking Cefixime and also take Omeprazole if acidity is developed. Please apply ''Liquid'' povidone iodine locally, only once and no ointments please. As discussed previously, it is important to have the cleaning with tap water at least twice daily may be with mild soap (soap should not be retained and plenty of water needed to clean the area, tap dry with cotton cloth or hair-dryer) Washing of the irritants due to hot and humid atmosphere helps a lot. Since your main symptoms are related to urination as you have mentioned in your present query, I think you may have urethritis and urinary tract infection. I hope this answer helps you for proper diagnosis and proper treatment. Please give feedback, the reports and the clear pictures. Please feel free to ask if you feel that there is a gap of communication.