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What Does The Following Urine Analysis Report Suggest?

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Posted on Mon, 31 Aug 2015
Question: Dear Doctor
My daughter XXXXXXX has completed 9 years on XXXXXXX 3 ,2015. She came down with a fever of 101 F on the night of Aug 5 ,2015. She also had slight dry cough. I took her to her pediatrician the next day and he said it could be a viral since the cough is dry and will wait for two days before putting her on antibiotics. He prescribed paracetamol (Dolo 250mg) for fever and Ascoril D for dry cough. The fever would come down(upto 100.5F) only after giving the 5ml dose of para and after 4-5 hours would shoot up to 102F to 103 F. The cough also worsened. I continued the medication till saturday morning ( 8.8.15) thereafter on advice of her paed I took her for a blood and urine test. I am attaching the reports on the next page. He prescribed a mild antibiotic because of her low wbc count (2900) amoxicillin ( Augmentin DDC) twice daily for five days and asked to continue the same para and cough syrup. The fever is still in the same range .The main concern was the presence of albumin in her urine which showed three + . Though doc said it could be because of the high fever we still need to recheck it once she is infebrile, ,maybe after a week or so. I am really freaked out after this as i googled it up and it showed up kidney disorders to presence of albumin in urine in urine analysis. Please help me doc and tell me whether i should really be concerned.(the report files are not gettg attached)
Urine analysis
General Examinaton          Result
Colour               Pale-yellow
Reaction               Acidic
Specific gravity          1.030
transperancy          hazy
sediment               absent

Chemical examination
albumin               +++
Sugar               Absent
Bile salt               Absent
Bile pigment          Absent
blood               Absent
ketones               Trace

Microspcopic examination
Pus cells                3-4/hpf
RBC               absent/hpf
Epithelial cells          1-2/hpf
Crystals               absent
yeast               absent
bacteria               absent
cast               absent
amorphous material          absent


And in blood test

WBC 2900/cmm ............................normal range 4000-11000/cmm
and bilirubin (direct) 0.4 mg/dl ....... upto 0.2mg/dl

rest all within normal range

rest all normal range
doctor
Answered by Dr. Diptanshu Das (37 minutes later)
Brief Answer:
Meftal P is more effective than paracetamol and should provide relief

Detailed Answer:
Hi

Thanks for asking on HealthcareMagic. I have carefully gone through the details and the reports and understand your concerns. Let me assure you that your doctor has addressed the issue properly. He has also been correct in prescribing amoxycillin for the low WBC count. I would not worry about the albumin in urine and would wait for the fever to subside. It is more likely to go away soon. As of now, keeping the temperature in control would be of primary concern. Meftal P (mefenamic acid) is more effective than paracetamol and should give relief if given. I would insist you to request your doctor to write it down so that you can fetch it from the pharmacy. It should be given only if she has fever but the minimum duration between doses is 6-8 hours. You can give steam inhalation along.

I do not think that you need to get concerned.

Feel free to write back in case of further queries and I would be glad to help.

Regards
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Diptanshu Das (20 minutes later)
He had initially also recommended Ibukind plus (ibuprofen and paracetamol) but after the urine test results he striked that off from the prescription. But the para still wasnt giving results so I called him again to ask for a substitute since the fever was always in the range of 100.5 to 102.5 even aftr giving her para. So he asked to give ibukind 10 ml ( her weight is 24 kg) as he said giving it twice or thrice wont do any harm as long as it is given in duration of 8 hrs.
Right now she still has a fever of 102 F but doesn't seem causing her any discomfort.
Should i give her a dose(10 ml) of ibukind now? The last medicine for fever ( dolo 250mg, 5 ml) was given at around 3 pm today.
doctor
Answered by Dr. Diptanshu Das (12 hours later)
Brief Answer:
Ibukind Plus may be given.

Detailed Answer:
Thanks for writing back. Sorry for not being available to answer your question earlier.

Ibuprofen+paracetamol can be given but only at 4 hours gap from the dose of paracetamol. If given, it is likely to relieve the temperature better than when only paracetamol is given. 15 ml should be the right dose required for your child but it might be ok if 10 ml is given. If she has fever, try giving ibukind and see plus and also give tepid sponging along.

Hope that helps.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Diptanshu Das (29 minutes later)
Thank you for the reply doctor

I did give Ibukind yesterday night at 12.23am . The fever came down and was 99.4 F till 11 am today morning. I checked again at about 12 pm and it slightly increased to 100.2F and fifteen min later it was 100.8F. If the temperature rises again to more than 101 or so, i can give another dose isn't it? Also she is hardly eating , ate only a slice of bread for breakfast. I gave the antibiotic (5ml) at 11.15am . She passed loose motions which the doctor has told would be expected because of the antibiotic. Now she is complaining of pain in the abdomen area. what can i do to relieve her from this pain? and she is scared of taking anything as she feels shes going to throw up if she does. Also while brushing she threw a little phlegm which was slightly red and yellow, y is that so? is this normal?
doctor
Answered by Dr. Diptanshu Das (19 minutes later)
Brief Answer:
these medicines are known to cause gastritis

Detailed Answer:
Thanks for writing back. Meftal P is more effective than ibiukind plus. Moreover, increasing the dose of ibukind plus to 15 ml could help. Be sure to give these in full stomack as they are known to cause gastritis. If there is another episode of temperature, you can give another dose but maintain the interval between doses. As of now give omeprazole once daily before food and digene or some antacids when she has pain.

I would not bother about the colour of phlegm. It is due to rhino sinusitis which can commonly remain associated. Give steam inhalation. The loose motion is due to antibiotics and all you need to do is to give ORS (oral rehydration solution).

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Diptanshu Das (25 minutes later)
Thank you soo much doctor for your immediate reply. Your replies are a real stress buster because unwanted thoughts creep into your mind.
The problem is she refuses to have anything and I am very worried because of that. And since you said meds are to be given on full stomach i really have no clue as to how fill her stomach even a little bit...
doctor
Answered by Dr. Diptanshu Das (2 minutes later)
Brief Answer:
It is normal for a child not to eat well when ill.

Detailed Answer:
I understand the situation but you have to see and try whatever you can give her to eat. An empty stomach increases the possibility of gastritis. Omeprazole will provide some protection.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Diptanshu Das (2 hours later)
Thank you once again Doc
She threw up cough which was yellow and little red here and there and that made made her feel better. She also said her stomach is not hurting any more
I am constantly checking her temperature. Its fluctuating from 100.5 to 101.5, but not causing her any discomfort. I haven't yet given a second dose of ibukind yet the last dost being yesterday night at 12.30am.I managed to give ten spoonfuls of rice porridge or kanji and she also had a banana. .Is the low grade fever of concern? I haven't given her the cough syrup (Ascoril D) too since yesterday (She really hates it !!). Do I hav to give it because its for dry cough. isn't it? Anything else I should be looking our for?
doctor
Answered by Dr. Diptanshu Das (10 minutes later)
Brief Answer:
Give steam inhalation

Detailed Answer:
Give ibukind plus if fever is above 100. You need not worry about lower temperatures. No problem if the syrup is not given but be sure to give steam inhalation. It provides relief in dry cough. As of now look out for signs of lethargy.
Otherwise you need not worry.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Diptanshu Das (2 hours later)
I gave another dose of Ibukind at around 3:30 pm .Now her fever is all gone and she is back to her normal self.Shes lethargic only when she has fever otherwise she s very active. Will do a steam inhalation later as per your advice. She had a little tea and a biscuit too. And shes now playing computer games! I am really relieved. And I am hoping the fever does not return after the fever medicine wears off. What else should i be looking out for ?
And another thing that's bothering me is her urine analysis results. I still cant get that out of my head. Should i be really concerned about the albumin levels? Please tell me doc what are the implications of the result. Have you ever come across abnormal levels of protein in routine urine analysis in otherwise healthy children ever in your practice? Whats the normal range?Should i do another test after her present condition has improved?
Waiting for your next reply
Thank you once again
doctor
Answered by Dr. Diptanshu Das (4 hours later)
Brief Answer:
Retest urine after she gets well.

Detailed Answer:
It is good to hear that your child is otherwise active except for when she has fever. I would consider it normal. I do not think that there is anything specific to look out for at the moment.

I would not worry about the urine at the moment. Certain infections can make the filtering membrane of the kidneys leaky. I have seen such cases. You have to retest after the fever subsides. Under normal circumstances no amount of albumin comes in urine.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (15 minutes later)
Thank you doctor for your reply. It really does more than energize me, and this gets rubbed of on my daughter as well.
I would still want to know ,are there infections that can affect kidney filters leaky enough to send albumin as much as 3+ into urine? could the test be wrongly printed or will she be having any kidney disorder? These are questions that makes me insane and I know its a bad idea to google up medical stuff but I just can't stop myself and it does more harm than good to my mental stability.
doctor
Answered by Dr. Diptanshu Das (12 hours later)
Brief Answer:
It is not unusual for albumin to appear in urine during fever.

Detailed Answer:
Once again sorry for not being able to respond earlier.
Since in case of fever it is not unusual, I would not worry as of now. I would therefore not try to frighten you unnecessarily by telling you about possibilities that I do not expect to play a role. In case you want a better understanding of the topic, you can go through the following links:
https://pedclerk.bsd.uchicago.edu/page/proteinuria
http://www.aafp.org/afp/1998/1001/afp0000p1145-f2.gif

Albumin is a protein and albumin in urine is proteinuria. Look at the 'Non-pathological causes of proteinuria' section.

Hope that clears your queries.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (12 minutes later)
Thank you doc.
But I only hope its just the fever that's causing it. Are there any symptoms to look out for in case its not just the fever? Like some pain or swelling or anything else that might be warning signs? In the links that you have sent, it does say that fever, exercise can lead to presence of albumin in urine. I really hope its only as much as its showing.
Today she is much better. No fever till now after the last dose of fever med administered was at 3:30 pm yesterday. She slept through the night without any fever too. Thank you very much for your encouraging words. Her doc asked to continue amoxicillin for another three days to complete the course.
Thank you once again doc

Regards
doctor
Answered by Dr. Diptanshu Das (4 hours later)
Brief Answer:
You need not worry.

Detailed Answer:
You may look out for swelling of face or body but since you have not reported such a thing till now, I do not think you need to worry about it. I do not think that you need not worry about anything more.

Its good to know that the fever is gradually subsiding.

Stay relaxed.

Wish you all the best.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (18 hours later)
Thank you doc!

She has never had any swelling anywhere on her body and still doesn't. Her fever is completely gone now,though there is weakness. She is coughing too and therefore scared to take her medicine lest she throws up. Nevertheless we try to give her proper meals of dosa, idli, rice dal, wheat bread etc. I have read cough takes a longer while to cure.
I will give for another urine analysis maybe next week or so. Should the urine be early morning urine? or can it be at any time of the day? So when i give it the next time the albumin levels should be nil or is there some minimum level? If yes , what is the normal range?
Please give me answers to these
Waiting for your reply
doctor
Answered by Dr. Diptanshu Das (2 hours later)
Brief Answer:
A decline in urinary albumin would indicate improvement.

Detailed Answer:
I have already insisted you not to get worried unnecessarily. Its good to hear that the fever has subsided. The weakness will take some time to resolve.

Wait for a week after the fever resolves completely. Thereafter get the urine tested. It is more preferrable to collect the first morning sample but samples can also be collected at other times of the day. The normal level of albumin is nil but even if some amount of albumin is present, you need not worry as it shows decline in albumin levels from the present levels.

Stop panicking unnecessarily.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (2 hours later)
Thank you so much doctor! I place you next to god , I have no words to express how thankful I am. Its disheartening to see her not active because i have nvr seen her lazying out nytime...now aftr d fever , since yesterday she sleeps in the aftrnoon so i was a littl worried...but she does get involved in some activities but fr short span .

Thank u doc
doctor
Answered by Dr. Diptanshu Das (50 minutes later)
Brief Answer:
Please bear your patience

Detailed Answer:
I understand your situation. But you need to understand that illnesses are a part of life and they take their toll on the body. For proper recovery the body needs time and rest and after that you can soon expect her to be back to normal. Please be patient till then.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (3 hours later)
I know no amount of thanks is gonna suffice nevertheless i want to say thanks a ton!
I gifted her with toys today for getting well and she is very happy and playing right now. Tomorrow she will be joining school . She seems weak from the fever but i know she will spring back in a week or so.
Doctor you have been like a balm through this turbulent phase of our lives. Me and my husband are really grateful to you for encouraging us through these trying times.I would like to know which hospital you practice if it ok to ask? And what are the timings of your consultation. Please ignore if its against the rules here.
Thanks again

Regards
doctor
Answered by Dr. Diptanshu Das (3 hours later)
Brief Answer:
Glad to be of service.

Detailed Answer:
I am glad to know that you found my answers helpful. In future you may feel free to ask me directly by visiting http://tiny.cc/DrDDas
You may contact me by any mode using the above link.

I am attached to Woodlands Multispeciality Hospital, XXXXXXX It is probably not in your vicinity, hence consultation hours probably do not apply.

In case you found my answers helpful, please leave a positive review and a 5 star rating for the answer.

Wish you and your family health.

Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
Answered by
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Dr. Diptanshu Das

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Practicing since :2005

Answered : 3878 Questions

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What Does The Following Urine Analysis Report Suggest?

Brief Answer: Meftal P is more effective than paracetamol and should provide relief Detailed Answer: Hi Thanks for asking on HealthcareMagic. I have carefully gone through the details and the reports and understand your concerns. Let me assure you that your doctor has addressed the issue properly. He has also been correct in prescribing amoxycillin for the low WBC count. I would not worry about the albumin in urine and would wait for the fever to subside. It is more likely to go away soon. As of now, keeping the temperature in control would be of primary concern. Meftal P (mefenamic acid) is more effective than paracetamol and should give relief if given. I would insist you to request your doctor to write it down so that you can fetch it from the pharmacy. It should be given only if she has fever but the minimum duration between doses is 6-8 hours. You can give steam inhalation along. I do not think that you need to get concerned. Feel free to write back in case of further queries and I would be glad to help. Regards