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My 9 Months Baby Has A Urinary Tract Infection
My 9 months baby boy (DOB:27 April 2010) had following problems in the same sequence 1. Very first time a drop of pus was observed flowing thru his penis(24th November 2010). 2. Routine report showed 20-22 /hpf pus cells and protein trace. 3. Culture report showed 1,10,000 colony count with organism E Coli 4. Was treated with norflox ( oral antibiotic) for 10 days 1/2 tablet twice a day 100 mg and tests were repeated 5. Routine report showed occasional pus cells. 6. Culture report showed 80,000 colony count with organism E Coli 7. MCUG report shows trabeculated bladder with dilated posterior urethra and a bladder diverticulum with Grade II reflux on right kidney . 8. Ultrasound report said Bladder shows slightly thickened and irregular walls May be seen in infection ADV: follow up A small suspicious diverticulum in the right posterior wall. 9. A urine catheter was then put on to him with IV antibiotics( Meropenem ) for 2 weeks. 10. Pediatric Surgeon said MCU is suspicious of PU valves. 11. As per suggestion of a Pediatric Surgeon he underwent thru a PU ( Posterior Urethral valves ) fulguration thru cystoscopy on 11th Jan. 12. He is kept on Magnex IV antibiotic for 6 post operative days along with the urinary catheter. 13. After a week catheter was removed. He was given Taxim-o oral antibiotic twice a day. 14. After one week of oral antibiotic unfortunately he again shows multiple pus cells in his urine report and again the same organism E-coli can be seen. 15. He is now again on 14 day IV antibiotic. 16. Pediatric surgeon now suggests that we need to do ureteral reimplant surgery. 17. Took a second opinion from another pediatric surgeon and he said that ureteral reimplant is not necessary and we should see that the infection is eradicated completely. 18. As of now he has fever about 100-101 and is been controlled by paracetamol/ibuprofen. If fever doesn t go down he is suggested to have an urine cather again to release the urine bladder pressure.
Fri, 23 Sep 2011
User's Response
Dr. Pankaj N Maheshwari's
Response
I agree with most of the treatment given.
Child surely needed cystoscopy with valve fulguration.
The further treatment would be to keep the child on supressive dose of antibiotics after the present infection is irradicated.
He may not need ureteric re-implantation as this is a secondary reflux.
Child surely needed cystoscopy with valve fulguration.
The further treatment would be to keep the child on supressive dose of antibiotics after the present infection is irradicated.
He may not need ureteric re-implantation as this is a secondary reflux.
User's Response
Milind's
Response
Thanks Dr. Pankaj for your quick reply. I appreciate your suggestion.
The current issue is that inspite of being on suppressive dose of oral antibiotics with sufficient dosage after fulguration, some how he again developed infection and now on fever even after 3rd day of antibiotic. We are going thru' 14 days of IV antibiotic course this time. I hope it gets eradicates this time.
The current issue is that inspite of being on suppressive dose of oral antibiotics with sufficient dosage after fulguration, some how he again developed infection and now on fever even after 3rd day of antibiotic. We are going thru' 14 days of IV antibiotic course this time. I hope it gets eradicates this time.
User's Response
Dr. Pankaj N Maheshwari's
Response
Surely you would.
In case of persistant infection I would suggest a repeat sonography to look for post-void residual urine. I would appreciate if you keep me informed about the progress.
Does he have any Phymosis?
Best wishes
In case of persistant infection I would suggest a repeat sonography to look for post-void residual urine. I would appreciate if you keep me informed about the progress.
Does he have any Phymosis?
Best wishes
User's Response
Milind's
Response
Had been for repeat sonography a few days ago to check the post void residual urine, but he was very cranky at that time and thus could not get it done that time. "Tropan" tablet was discontinued at that time for few days by Pediatric surgeons advice. Now after Urologist's suggestion Tropan has started again and he seems to be comfortable urinating and appears less cranky. I will definitely keep you posted.
No, I don't think he has Phymosis.
One thing that worries me Dr. Pankaj is the following 2 statements in the article in the following link
"http://www.urologychannel.com/pediatric/vur_treatment.shtml"
Statement 1
Secondary reflux that does not resolve with antibiotic treatment, or that results in UTI despite antibiotic therapy (called breakthrough infections), and primary reflux that is severe (grades IV and V) require surgery to prevent permanent kidney damage.
Statement 2
A breakthrough urinary infection, in spite of preventive antibiotics, is a dangerous situation indicating that there is not enough time for spontaneous resolution and that the next step should be surgical correction of reflux
Will like to know your view on this.
No, I don't think he has Phymosis.
One thing that worries me Dr. Pankaj is the following 2 statements in the article in the following link
"http://www.urologychannel.com/pediatric/vur_treatment.shtml"
Statement 1
Secondary reflux that does not resolve with antibiotic treatment, or that results in UTI despite antibiotic therapy (called breakthrough infections), and primary reflux that is severe (grades IV and V) require surgery to prevent permanent kidney damage.
Statement 2
A breakthrough urinary infection, in spite of preventive antibiotics, is a dangerous situation indicating that there is not enough time for spontaneous resolution and that the next step should be surgical correction of reflux
Will like to know your view on this.
User's Response
sufia's
Response
Hi welcome to healthcare magic.
my sincere advice to you is go for alternative medicine. the baby is already suffering a lot with UTI.,you are adding more sufferings to that small boy by giving IV's, doing painful investigations.... OZONE therapy is best option. ozone has a very strong germicidal effect. it can be given through rectum, which will not hurt the baby much. Bladder irrigation with ozone water is also beneficial. combine this with homoeo medicines which can be easily accepted by children and also safe for them. for more details contact me at sufia_banu@yahoo.com
my sincere advice to you is go for alternative medicine. the baby is already suffering a lot with UTI.,you are adding more sufferings to that small boy by giving IV's, doing painful investigations.... OZONE therapy is best option. ozone has a very strong germicidal effect. it can be given through rectum, which will not hurt the baby much. Bladder irrigation with ozone water is also beneficial. combine this with homoeo medicines which can be easily accepted by children and also safe for them. for more details contact me at sufia_banu@yahoo.com
hello and welcome to health care magic ,please note that fever would be there as long as urinary tract infection would continue ,and as there is reflux on right kidneys-so there
are chances of re-infection,would give advice to get consulted with urologist to have a better opinion,take care
are chances of re-infection,would give advice to get consulted with urologist to have a better opinion,take care
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