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What Is The Cause For High ESR And What Is The Treatment For E.Coli?

Posted on Fri, 10 Jan 2014

Question: My father, 77 yrs, have been presently detected E.Coli upon urine anlysis with ESR 66 and CRP 3.5.His total count is about 14600. Past history is to be noted that sbout 6 weeks ago, his total count was 26200 with ESR 50 and CRP 14. But at that time E.Coli was not detected. CT brain, Eco cardiogram and ECG of heart, USG of whole abdomen revealed nothing, except adenomyastotits of gallbladder and mild pleural effusion in lungs for which Chest PA was done which found lungs clear. Augmentin (amoxicillin & potassium clavulanate) for 10 days followed by Alevo ( Livofloxacin) for 10 days was given, which brought Total Count to 7500, ESR 10 & CRP <0.5. This means that the medicines then had worked very well and brought the infection under control. The medicine was stopped (b'coz e coli at that time was not detected). In about 2 weeks from then, the symptoms came back, with TC 18000, ESR 45, CRP 3.3, urine analysis revealed pus cells plenty, protein, blood 3-4, bacteria excess, and culture confirmed E.Coli. Now being administered Martifur MR 100 twice a day. Upon 6 days from start of mefivine, urine analysis only shows pus cells 8-10/hpf, culture report pending, blood showed TC 14600, ESR 66, CRP 3.5. All other tests eg. PSA, Urea, creatine normal. His general condition has also improved. No fever. Please advise on the reason for high ESR and treatment of E.Coli.

Answered by Dr. Shoaib Khan (1 hour later)

Brief Answer: ESR may take time to settle; urine culture Detailed Answer: Hello and welcome. Thank you for writing to us. I have gone through your query with diligence and have analysed all the details. In my opinion the best option right now would be an investigation called a urine culture and sensitivity examination. This investigation provides us on information about the most effective medication that can be used to treat the infection rapidly and effectively. So please request for the same, and initiate the most effective and suitable medication for your father. I would also like to address the fact that this is a recurrent infection, which means there is some underlying source that is causing the infection to return. I would request you to discuss the same with your father's doctor and find the cause. If there is an underlying cause, the infection will return no matter how many times you treat it and how effectively you treat it. As for the high ESR, ESR levels take time to come down sir, and it has been only 6 days since the initiation of the antibiotics; sometimes the levels take time to come down. Do not worry about that. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

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