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What Is The Cause And Treatment For UTI In A Child?

Posted on Tue, 7 Oct 2014

Question: sir my two years daughter has stool test report as follows:
Ova: Absent
cyst: Absent
Red cells: 5-7/HPF
Pus Cells: 15-20/HPF
Macrophages:Absent
Parasites: Absent
Mucus: Present
Colour: Yellow

Bacterial Flora of mixed Bacilli...

And Urine test result is:
Pus cells: Occ/HPF
Epthetial cells: Few/HPF
RBC: Occ/HPF
Crystal: Nil/HPf
Bacteria : Present
Cast: Nil/HPF
PH: 6
Colour: yellow
Turbidity: Absent
Deposit: Absent
Specific Gravity: QNS
Protein: Absent
Sugar: Absent
Sir pls help.. what is problem with my child...I am to worry...

Answered by Dr. Deepak Kishore Kaltari (19 minutes later)

Brief Answer:
It is due to Urinary tract infection

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Mr XXXXXXX

From the report made available it looks like your daughter has urinary tract infection. If it is the first episode there is nothing to worry. Antibiotics and adequate intake of water will take care of it.
Do get back to me with detailed symptoms she is having. Aslo let me know the following additional information
1. Is she having fever?
2. Symptoms and duration of symptoms

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh
Consultant Pediatric Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (1 hour later)

symptoms: weight loosing, vomiting, less appetite from last 3 months but having no fever yet..

Her treatment is going on for Tuberculosis from last 3 months...
Her blood report as follows on date 15/06/2014:

Hemoglobin: 7.1gm/dl
TLC: 9500/cumm
Neutrophil: 39%
Lympocyte: 58%
Eosinophil: 3%
Monocite: 00%
Basophil: 00%
ESR: 18mm
Mountox: 13mm

Digital X-ray: Normal (on date 17/06/14)

Stool report on date 14/06/2014

Ova: Absent
cyst: Absent
Red cells: 2-3/HPF
Pus Cells: 3-4/HPF
Macrophages:Absent
Parasites: Absent
Mucus: Present
Colour: Yellow

And Urine test result are on 14/06/2014
Pus cells: 1-2/HPF
Epthetial cells: NIL
RBC: NIL/HPF
Crystal: Nil/HPf
Cast: Nil/HPF
PH: 6
Colour: yellow
Deposit: Absent
Specific Gravity: 1.010
Protein: Absent
Sugar: Absent
after giving 1 unit of Hemoglobin... then report was on date: 19/06/14

Hemoglobin: 13.9 gm/dl
CRP: 2.05 mg/dl

doctor says after this report she has Tuberculosis.. doctor starts her treatment as follows on date 19/06/14
1. One tablet of Macox-ZH kid one time in a day(morning time)
2. Farbisure syrup 5ml twice in a dy
3. Apisper syrup 5 ml twice in a dy

she was good in health up to 1.5 months( August first week 2014)... but after first week of august 2014 she starts again vomiting and weight loosing.. Doctor gave her vomiting medicine Emigo. Her vomiting remain stop until we give her Emigo when doctor says to stop emigo then she starts vomiting again after 2 days of leaving.

now doctor advice me do urine report and stool test on date 12/09/14.. which i have told you as:
Ova: Absent
cyst: Absent
Red cells: 5-7/HPF
Pus Cells: 15-20/HPF
Macrophages:Absent
Parasites: Absent
Mucus: Present
Colour: Yellow

Bacterial Flora of mixed Bacilli...

And Urine test result is:
Pus cells: Occ/HPF
Epthetial cells: Few/HPF
RBC: Occ/HPF
Crystal: Nil/HPf
Bacteria : Present
Cast: Nil/HPF
PH: 6
Colour: yellow
Turbidity: Absent
Deposit: Absent
Specific Gravity: QNS
Protein: Absent
Sugar: Absent

Sir i am very confused that she has Tuberculosis or not? if have then why she is not normal after 3 months of treatment? why she is vomiting, weight loosing? Doctor is doing writ treatment or not?

Answered by Dr. Deepak Kishore Kaltari (13 hours later)

Brief Answer:
symptoms likely due to colitis

Detailed Answer:
Hi

Dear XXXXXXX

Diagnosis of Tuberculosis would have been based on positive Montoux test. Chest X ray being normal is very much reassuring. Ideally after initiation of Anti tuberculosis treatment there should be improvement in symptoms within 2 to 3 weeks.
Persistence of symptoms or reappearance of symptoms requires reevaluation. Vomiting could be due

1. Drug induced gastritis inducing vomiting
2. Colitis : It is more likely in view of presence of pus cells and blood in stools

If there is no distension of abdomen there is no cause for concern. Treatment of Colitis is important. I would suggest the following
1. Antibiotics: Metronidazole for 7 days
2. Anti emetic like Ondansetaron

If the symptoms persists she will require further reevaluation by Pediatric Surgeon.

Take care

Best regards
Dr Deepak

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. Chakravarthy Mazumdar