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What Causes Puss Cells In Urine?
Question: My 4 years old son suffered from UTI 15 days back. Initial urine report said plenty of Pus cells in Urine and the CBP reported with 26000 WBC count. After 4 days hospitalization with 5 dose of Amikacin injection urine report said as 1- 2 hpf of pus cell. Treatment continued for 7 days with cephalexin 250 mg syrup. Now after 7 days of completing antibiotic course urine report is with 1-2 hpf puscells. Does it mean UTI is completely cured or still persist? Should my son required further treatment
Brief Answer:
Yes but depends upon WBC and Symptomatic reileif
Detailed Answer:
Hi.
Thanks for your query.
Hi before I give the answer I would like to know:
How much is the WBC count now?
Was the urine sent for culture and sensitivity? If yes, what is the report?
How is your son? Any sign of infection like fever? Does he touch penis tip while urinating? Or is disturbed to pass urine? Was ultrasound of the abdomen done to find out the position of the urinary system or stone/s?
Since the report is showing 1-2 pus cells in urine test done two times, one can say he is cured of the infection. To add on the WBC should be within normal limits. Ultrasonography should be normal. Since your son is only 4 years it is not expected to tell us the symptoms. It is going to be the observations of the parents about his playfulness and no disturbance while passing urine.
If all the factors are as I noted you can be assured to day that your son is cured.
As an old rule- the antibiotics should be given for 3 weeks ( when the antibiotics were limited in old times). The newer antibiotics are fast working and may need to be given for a less than 3 weeks duration. Since you are giving Cefalexin, there is no harm to give it for one more week.
Somehow see that He takes lots of oral fluids ( again tricky for a 4 year old boy)
I hope I have given you necessary insight.
Yes but depends upon WBC and Symptomatic reileif
Detailed Answer:
Hi.
Thanks for your query.
Hi before I give the answer I would like to know:
How much is the WBC count now?
Was the urine sent for culture and sensitivity? If yes, what is the report?
How is your son? Any sign of infection like fever? Does he touch penis tip while urinating? Or is disturbed to pass urine? Was ultrasound of the abdomen done to find out the position of the urinary system or stone/s?
Since the report is showing 1-2 pus cells in urine test done two times, one can say he is cured of the infection. To add on the WBC should be within normal limits. Ultrasonography should be normal. Since your son is only 4 years it is not expected to tell us the symptoms. It is going to be the observations of the parents about his playfulness and no disturbance while passing urine.
If all the factors are as I noted you can be assured to day that your son is cured.
As an old rule- the antibiotics should be given for 3 weeks ( when the antibiotics were limited in old times). The newer antibiotics are fast working and may need to be given for a less than 3 weeks duration. Since you are giving Cefalexin, there is no harm to give it for one more week.
Somehow see that He takes lots of oral fluids ( again tricky for a 4 year old boy)
I hope I have given you necessary insight.
Above answer was peer-reviewed by :
Dr. Raju A.T
Now we have not done CBP. Initially Culter and sensitivity test done and it was E Coli, resistant to most of the oral antibiotics including Cephelaxin,etc.. sensitive to injectables like Amikacin,etc..,not advisable for children like Nitrofurantoin and etc... Initial Ultra sound of abdomen found with urinary bladder thickening, otherwise normal. After treatment no CBP & Ultrasound done. From the initial itself he had no fever or any other symptoms except severe pain while passing urine. Certain point of time he had severe / unbearable stomach pain & penis pain even while not urinating. All these symptoms are not present now. Our doubt is as we are feeding the child with plenty of oral fluids, is the infection and symptoms temporarily subsidised due to fluids? Once the fluid intake become normal, will the symptoms and infection come out again due to the persistance of infection in the tract? And to add, Though the E Coli strain is resistant to Cephelaxin Doctor has prescribed the same.
Brief Answer:
Find out the reason of thickened urinary bladder
Detailed Answer:
Hi,
Thanks for your feedback.
To get the most important thing first:: the ultrasound showed '' bladder thickening''.
This has to be investigated first.
The probable reasons are : Obstruction to the outflow of urine from bladder, particularly in a child due to urethral valves (to be ruled out by the Urologist either by cysto-urethroscopy / Urethrogram), tight phimosis, pin-hole meatus to name the most common causes.
Bladder thickening is to be investigated and treated, this is the sure-shot way to cure the UTI.
Extra fluids do not subside the symptoms.
Well the culture and sensitivity is only a helpful guide and the personal preference by your Doctor by experience , safety of medication are important factors among many. I too would go for Cephalexin as this works well and with the least side effects.
Repeat the Hemogram (WBC), Ultrasonography, Consult an Urologist, get further investigations and follow the advise of your Urologist.
Find out the reason of thickened urinary bladder
Detailed Answer:
Hi,
Thanks for your feedback.
To get the most important thing first:: the ultrasound showed '' bladder thickening''.
This has to be investigated first.
The probable reasons are : Obstruction to the outflow of urine from bladder, particularly in a child due to urethral valves (to be ruled out by the Urologist either by cysto-urethroscopy / Urethrogram), tight phimosis, pin-hole meatus to name the most common causes.
Bladder thickening is to be investigated and treated, this is the sure-shot way to cure the UTI.
Extra fluids do not subside the symptoms.
Well the culture and sensitivity is only a helpful guide and the personal preference by your Doctor by experience , safety of medication are important factors among many. I too would go for Cephalexin as this works well and with the least side effects.
Repeat the Hemogram (WBC), Ultrasonography, Consult an Urologist, get further investigations and follow the advise of your Urologist.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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