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Suggest Treatment For Kidney Infection, Fever And Back Pain
Question: I've had 2 rounds of antibiotics for kidney infection, fever, pain in the back. They cultured it and then changed the antibiotic. Went back to the urologist (after having to go to the ER) and they changed antibiotic to macrobid. originally Keflex, then levoquin. They did a CT scan and found a few kidney stones. It seemed to clear up last week. Now I'm having the pain in the back, urine pain, did an AZO test and the leukocytes came back high but no nitrates? I'm so confused.... In my 40's (woman and had a hysterectomy) just for some background information.
Brief Answer:
It might be a severe infection that you have or stones causing the pain
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Keflex (cephalexin) and Levoquin (levofloxacin) are systemic antibiotics used in treating urinary tract infections in many patients.
2. Macrobid (Nitrofurantoin) is an antibiotic that is specific for infections in the urinary system. This is because the medicine gets concentrated in the urine in sufficient mount to control the bacteria and treat the infection. In most cases this is highly effective for treating UTIs. I hpe you have taken it as recommended by your doctor and for the complete course.
3. It is important to know a little more in detail about your kidney stones. This is because a stone which is stuck at any of the strategic locations might cause mild to severe pain. Please send the CT scan report as that I might now any possibility of a stone causing onstruction to flow of urine and mild infection that is causing the pain and leukocytes.
4. The other possibility is that there might be continuing infection in the bladder with bacteria that do not produce nitrites and which might be resistant to macrobid. In this case there is a need to repeat urine culture and sensitivity test and then proceed with medicines which are effective against a particular type of bacteria.
5. Please discuss the possibilities with the urologist if you require a slightly longer duration of treatment because it appears that you have a severe UTI. At the same time a discussion on the location of the kidney stones and their size would help to know if they might cause any problem in the future. Please continue to drink adequate amounts of water and void urine regularly and this will help to flush the system.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
It might be a severe infection that you have or stones causing the pain
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Keflex (cephalexin) and Levoquin (levofloxacin) are systemic antibiotics used in treating urinary tract infections in many patients.
2. Macrobid (Nitrofurantoin) is an antibiotic that is specific for infections in the urinary system. This is because the medicine gets concentrated in the urine in sufficient mount to control the bacteria and treat the infection. In most cases this is highly effective for treating UTIs. I hpe you have taken it as recommended by your doctor and for the complete course.
3. It is important to know a little more in detail about your kidney stones. This is because a stone which is stuck at any of the strategic locations might cause mild to severe pain. Please send the CT scan report as that I might now any possibility of a stone causing onstruction to flow of urine and mild infection that is causing the pain and leukocytes.
4. The other possibility is that there might be continuing infection in the bladder with bacteria that do not produce nitrites and which might be resistant to macrobid. In this case there is a need to repeat urine culture and sensitivity test and then proceed with medicines which are effective against a particular type of bacteria.
5. Please discuss the possibilities with the urologist if you require a slightly longer duration of treatment because it appears that you have a severe UTI. At the same time a discussion on the location of the kidney stones and their size would help to know if they might cause any problem in the future. Please continue to drink adequate amounts of water and void urine regularly and this will help to flush the system.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for answering. I had the CT scan a few weeks ago and they said I had 4 stones, all to which were in the kidney, and no obstruction. They repeated a test and said the UTi seemed to be clearing up. They provided me steroids and I felt a lot better until a few days ago. Now I have the back pain, bladder pain again. I am going back to the urologist today but am frustrated because I don't want him to say the stones aren't causing you any issue, the ursine is clear and then I'm at a loss to why having these symptoms. I don't have a copy of the ct scan they just called and told me on the phone.
Any other suggestions or tests that he could possibly run besides just stating everything seems ok and I have to love with feeling like someone is kicking me in the back? Thank you for your help..
Any other suggestions or tests that he could possibly run besides just stating everything seems ok and I have to love with feeling like someone is kicking me in the back? Thank you for your help..
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. If you were my patient then I would have put you through a urine culture and sensitivity test to know if you have any persisting infection causing leukocytes.
2. If the culture turned out negative then I would have proceeded with suggesting a cystoscopy to know any problems inside your urinary bladder. Since the stones were non obstructive, I feel that they would not be causing the pain, though I would like to do an ultrasound scan for double confirmation.
3. Though you have not mentioned in your query, I would like to know if you ever had lower back pain problem which might be related to discs in the spine from pinching of nerves leading to intermittent pain in the back.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. If you were my patient then I would have put you through a urine culture and sensitivity test to know if you have any persisting infection causing leukocytes.
2. If the culture turned out negative then I would have proceeded with suggesting a cystoscopy to know any problems inside your urinary bladder. Since the stones were non obstructive, I feel that they would not be causing the pain, though I would like to do an ultrasound scan for double confirmation.
3. Though you have not mentioned in your query, I would like to know if you ever had lower back pain problem which might be related to discs in the spine from pinching of nerves leading to intermittent pain in the back.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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