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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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74 Years. Low Fever, Lack Of Appetite, Presence Of Pus Cells In Urine. History Of UTI Followed By Turp And Hernia Operation. No Help From Antibiotics. Guide

My father is 74, patient of UTI followed by turp and harnia operation. pus cells plenty, having low grade fever last 1 and half months...doc. suggest few antibiotics like amikcin iv 10 days completed, then ceftreazone then azythromycin, then ciprofloxacin..but he still having fever, no change, no appetite, getting weak..
Fri, 19 Jul 2013
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General & Family Physician 's  Response
Hello,
Thanks for the query to H.C.M. Forum.
As you stated in your query that there is pus cells in urine .
Low grade fever.
Prostate and hernia operated.
Fever is there from last 45 days.
Amikasin, cipro, cetriazone, azythromycin i.e. gram positive and gram negative antibiotics given , no relief.
Get in blood culture and drug sensitivity test .
Get urine culture .
It seems as infection is in the kidneys and chances of chronic renal failure is there .
So consult an Urologist and get his opinion and treatment.
Alternatively upload reports of SERUM CREATININE & BLOOD UREA for diagnostic purpose.
Hope I have answered your question.
If further any question I will help.
Good luck.
Dr. HET
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General Surgeon Dr. Venkat Narayana Badipatla's  Response
Hello,

I had gone through your father's problem. You had written that your dad had UTI following TURP and hernia operation. But was his UTI diagnosed. Having plenty of pus cells in urine is not enough to make diagnosis of UTI. It should be confirmed with urine culture and sensitivity. You had written that he is having fever for the last 1 and half months, loss of appetite and getting weak. Usually Tuberculosis of urinary tract can cause sterile pyuria (plenty of pus cells in the urine but with negative urine culture) and also low grade fever with loss of appetite. Usually this will not be cured with antibiotics. only ATT can cure this condition. To diagnose tuberculosis of urinary system, urine PCR should be done which detects tubercular DNA.

My advice is to consult a urologist and get the urine PCR done to rule out tuberculosis.

good luck
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  User's Response
Hi, many thanks for the query!
What was the histopathological diagnosis of the resected specimen of prostate?
Benign or malignant? Sr. PSA levels before TURP?
You need to do- USG (Abdo-Pelvis), CBC, RFT, Urine (Culture & Sensitivity)
and as per the report, start antibiotics by parenteral route if needed with your Urologist's opinion.
Also do- Blood Sugar Level & if diabetic, good control of blood sugar is necessary while treating UTI.
Wish you a good health.
Take care.
Regards.
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General & Family Physician Dr. Chirag Soni's  Response
Welcome to HCM.
You have to go for certain investigations like CBC,URINE routine/micro and cs,FBS,PPBS. Start proper antibiotic after urine cs report,it will definitely recover after taking it.Drink enough water and other liquids.treat any other underlying condition after reports.
Keep proper follow up to your doctor and ask every thing to him.
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74 Years. Low Fever, Lack Of Appetite, Presence Of Pus Cells In Urine. History Of UTI Followed By Turp And Hernia Operation. No Help From Antibiotics. Guide

Hello, Thanks for the query to H.C.M. Forum. As you stated in your query that there is pus cells in urine . Low grade fever. Prostate and hernia operated. Fever is there from last 45 days. Amikasin, cipro, cetriazone, azythromycin i.e. gram positive and gram negative antibiotics given , no relief. Get in blood culture and drug sensitivity test . Get urine culture . It seems as infection is in the kidneys and chances of chronic renal failure is there . So consult an Urologist and get his opinion and treatment. Alternatively upload reports of SERUM CREATININE & BLOOD UREA for diagnostic purpose. Hope I have answered your question. If further any question I will help. Good luck. Dr. HET