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What Causes Mesenteric Adenitis In Children?
Question: My 10 yr old daughter was recently diagnosed with mesentery adenitis. along with a uti. Last night and today she is having severe abdominal and right side (lower back) cramping. Is there anything I can do to help ease this pain? A cat scan, ultrasound, blood work and urinalysis were all performed the 2x we were in the hospital within the last 2 weeks. Does it take this long for this type of infection to get out of her system, or could this be something more?
XXXXXXX Williamson
Brief Answer:
UTI may need long duration to resolve completely
Detailed Answer:
Hello
Thanks for the query
Both UTI and mesenteric adenitis are common causes of pain abdomen in this age group.
In case of UTI apart from urinary analysis,ultrasound of the kidney should be done.Your daughter has been investigated thoroughly.
Sometimes it is really difficult to get the bacteria clear from the urinary tract particularly when there is involvement of upper urinary tract..Antibiotic treatment may need to be given for 2-3 weeks(more in case of upper UTI) and after that child may put on prophylaxis treatment depending on the severity.
Plenty of fluids need to be given to flush the tract and clear the bacteria for better effect of antibiotic.
I would like to know the reports whether urine examination showed any bacteria and if yes then what was the sensitivity pattern.
Please tell me about the USG findings too.
Mesenteric adenitis can be a coincidental finding and is important when there are no other causes for pain abdomen.In most of the cases it get resolved with antibiotic treatment.
Crampy abdominal pain is characteristic of UTI.Some antispasmodic medication(drotavarine/dicyclomine) helps in relieving the condition.
Please let me inform about the medications also.
Waiting for you reply.
Regards
UTI may need long duration to resolve completely
Detailed Answer:
Hello
Thanks for the query
Both UTI and mesenteric adenitis are common causes of pain abdomen in this age group.
In case of UTI apart from urinary analysis,ultrasound of the kidney should be done.Your daughter has been investigated thoroughly.
Sometimes it is really difficult to get the bacteria clear from the urinary tract particularly when there is involvement of upper urinary tract..Antibiotic treatment may need to be given for 2-3 weeks(more in case of upper UTI) and after that child may put on prophylaxis treatment depending on the severity.
Plenty of fluids need to be given to flush the tract and clear the bacteria for better effect of antibiotic.
I would like to know the reports whether urine examination showed any bacteria and if yes then what was the sensitivity pattern.
Please tell me about the USG findings too.
Mesenteric adenitis can be a coincidental finding and is important when there are no other causes for pain abdomen.In most of the cases it get resolved with antibiotic treatment.
Crampy abdominal pain is characteristic of UTI.Some antispasmodic medication(drotavarine/dicyclomine) helps in relieving the condition.
Please let me inform about the medications also.
Waiting for you reply.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for your response. The hospital did a cat scan 10 days ago of her lower abdominal area, her kidneys, bladder, appendix and found nothing abnormal with any of these organs. The CT scan showed inflammation of the lymph nodes in the mesentary. At the same time, (the day before) we had visited her primary and her primary dr. found blood in her urine and determined she had a uti. So she has 2 different things going on. The hospital did not give her any antibiotic. They gave her hydrocodone for pain. Her primary prescribed Cipro for the uti, which we are still taking, as well as the hydrocodone for pain like she has had today. WE have a follow up with her primary on Monday, but it is the pain that is really, really bad, and not just when she has to use the bathroom.
Brief Answer:
I would like to reevaluation of CT report and to rule out renal stone
Detailed Answer:
Presence of blood in urine(hematuria) with severe crampy abdominal pain is characterestic of renal/ureteric stone.
Although infection is the most common cause of hematuria,it is usually associated with other symptoms like fever,burning micturition,increased or decreased frequency of urine.Usually such severe crampy pain is not common in UTI.
In urine examination also there should be features suggestive of UTI other than hematuria like presence of pus cells,protein,casts etc.
There can be other uncommon causes of hematuria but symptoms are not suggestive.
Ciprofloxacin has good coverage for the organisms causing UTI. Hydrocodone is an opioid analgesic and works well in crampy pain.
But the question in mind is that the test like USG and CT scan both are normal.In the presence of stone it should be get detected.
CT scan causes radiation harm and USG is free of any radiation injury.
In the present situation I would like to get the CT report reevaluated and get a repeat USG done if the symptom persists for more than 5-7 days.
Also a repeat urine examination should be done to see whether urine is clear of blood or any new finding is there in urine.
Ask me if you have any more concerns,I shall be glad to help you out.
Regards
I would like to reevaluation of CT report and to rule out renal stone
Detailed Answer:
Presence of blood in urine(hematuria) with severe crampy abdominal pain is characterestic of renal/ureteric stone.
Although infection is the most common cause of hematuria,it is usually associated with other symptoms like fever,burning micturition,increased or decreased frequency of urine.Usually such severe crampy pain is not common in UTI.
In urine examination also there should be features suggestive of UTI other than hematuria like presence of pus cells,protein,casts etc.
There can be other uncommon causes of hematuria but symptoms are not suggestive.
Ciprofloxacin has good coverage for the organisms causing UTI. Hydrocodone is an opioid analgesic and works well in crampy pain.
But the question in mind is that the test like USG and CT scan both are normal.In the presence of stone it should be get detected.
CT scan causes radiation harm and USG is free of any radiation injury.
In the present situation I would like to get the CT report reevaluated and get a repeat USG done if the symptom persists for more than 5-7 days.
Also a repeat urine examination should be done to see whether urine is clear of blood or any new finding is there in urine.
Ask me if you have any more concerns,I shall be glad to help you out.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
In her urinalysis her dr. found protein. The levels were +2. Nothing was ever mentioned about a renal stone, but a possible kidney stone was. She has had no fever, a little dizziness and her blood pressure has been around 104/64. She is resting now and I have been giving her motrin for the pain along with the hydrocodone. Her primary is going to do another urinalysis on Monday.
Brief Answer:
Renal stone and kidney stone is same
Detailed Answer:
I would continue the present treatment and will wait for the report of repeat urine analysis.2+ protein is a very nonspecific finding and should be corroborated with other clinical and laboratory finding.Both kidney and renal stone are same and may need to be evaluated properly.
Regards
Renal stone and kidney stone is same
Detailed Answer:
I would continue the present treatment and will wait for the report of repeat urine analysis.2+ protein is a very nonspecific finding and should be corroborated with other clinical and laboratory finding.Both kidney and renal stone are same and may need to be evaluated properly.
Regards
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Above answer was peer-reviewed by :
Dr. Yogesh D
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