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What Does This Blood Report Indicate?

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Posted on Mon, 29 Aug 2016
Question: Hi Dr XXXXXXX
Our daughter's liver is much better now with her bilirubin down to 91 (from 680), which is great.
But she is back in hospital with an infection. Her white and red cell counts are way out of range.
Following are her results from today. All the doctors will say is that she has an infection and its a possible UTI. They have said that her kidneys appear to be coping (the Urea, Creatinine, GFR etc are all within range). Only thing that is slightly out of range is the Urate at 0.11. She has tested positive for EColi in her blood, and her urine shows Leucocytes 160, Erythrocytes 30, and Epithelials 20. Can you tell me if this is an easy fix with IV treatments, or are the following levels life threatening?
Thank you Dr XXXXXXX
Regards XXXX
Haemoglobin      79
White Cell Count     2.8
Platelet Count      68
Haematocrit      0.23
Red Cell Count     2.39
MCV      95
Neutrophilis      1.33
Lymphocytes      0.88
Monocytes      0.59
Eosinophils      0.04
Basophils      0.00
doctor
Answered by Dr. Tayyab Malik (1 hour later)
Brief Answer:
Hopefully, the patient would RECOVER soon.

Detailed Answer:
hi Mrs XXXXXXX
thank you for posting a direct question to me.
i would try to reply in the best of my capacity after going through the question and lab results.

Firstly, your daughter is very strong and she fought liver failure and she would recover from the infection very soon.

it mostly looks like acute UTI.
most strains of E.coli are "NOT" lethal and the infection is self-limiting. The RBC and WBC would recover as the infection ceases.

I would suggest you to ask the treating physician if the patient is tested for "O157:H7 strain" of E.coli. Infection with this strain does not carry a life-threatening risk but The strain should be monitored carefully.

However, as a whole, there is nothing to worry about.
no life threatening situation.
the patient just needs to rest, be compliant with medication. Blood tests would be monitored.

wish her with speedy recover along with good and sound health thereafter.

hope to answer your concern.
further questions are most welcomed.

regards
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Tayyab Malik (29 hours later)
Thank you Dr XXXXXXX
Your detailed replies are exactly what we need to know.
Your assistance is very much appreciated.
Kind Regards
XXXX
doctor
Answered by Dr. Tayyab Malik (7 hours later)
Brief Answer:
your welcome.

Detailed Answer:
Hi.

It's pleasure to be of any help.

Kindly close the dialogue box and rate answer if no further questions.

Wish your daughter speedy recovery along with good and sound health thereafter.

Thank you.

Kind Regards
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Tayyab Malik (3 days later)
Hello Dr XXXXXXX
Yes you were correct, it was a UTI, but we were told that the infection had gone into her blood stream, and her doctors were all full of doom and gloom for a couple of days until they were able to grow cultures and work out what it was exactly, and then they were a little less pessimistic as they could treat it with the correct antibiotics.
Our daughter is recovering from these infections as predicted, however she still has a lot of pain in her left side. And she also vomited blood (Dark and fresh) whilst she was in hospital. But the doctors didn't seem too concerned about either of these conditions. It is a concern to us as they have always said that if our daughter experiences either of these then she should go back to hospital straight away.
All they have said about the pain is that it is probably a result of the kidneys taking a hit with the infection and will take a while to feel better from it. She has had the pain for nearly two weeks now and it is not feeling any better over time and medications for the infection.
Any suggestions on what it could be. Nothing showed up on a CT or XRay, should we be doing any other test for the reason for this pain, or is it just part of the process?
Good news is that her bilirubin is now down to 70!
Regards
XXXX
doctor
Answered by Dr. Tayyab Malik (7 hours later)
Brief Answer:
kindly read detailed answer below

Detailed Answer:
hi.
thanks for posting the query.

glad to know that your daughter health is improving gradually ( and bilirubin level is heading towards normal) ; though pain persists and she experienced an episode of hematemesis ( blood vomiting).

firstly, analgesics ( pain killer) maybe used to subside the pain. if medication for pain is already being used and NO effect, then switching the drug.
UTI; particularly involving kidney; results in pain that subsides with healing and passage of time.

secondly, if there was only a single episode of hematemesis , then observation is sufficient. However, if multiple episodes of hematemesis , then upper GI endoscopy is recommended.

lastly, monitor the UTI by having urinalysis test regularly until infection is completely healed.

hope to answer your concerns.
It's pleasure to be of any help.

Kindly close the dialogue box and rate answer if no further questions.

Wish your daughter speedy recovery along with good and sound health thereafter.

Thank you.

Kind Regards
Dr Tayyab Malik
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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What Does This Blood Report Indicate?

Brief Answer: Hopefully, the patient would RECOVER soon. Detailed Answer: hi Mrs XXXXXXX thank you for posting a direct question to me. i would try to reply in the best of my capacity after going through the question and lab results. Firstly, your daughter is very strong and she fought liver failure and she would recover from the infection very soon. it mostly looks like acute UTI. most strains of E.coli are "NOT" lethal and the infection is self-limiting. The RBC and WBC would recover as the infection ceases. I would suggest you to ask the treating physician if the patient is tested for "O157:H7 strain" of E.coli. Infection with this strain does not carry a life-threatening risk but The strain should be monitored carefully. However, as a whole, there is nothing to worry about. no life threatening situation. the patient just needs to rest, be compliant with medication. Blood tests would be monitored. wish her with speedy recover along with good and sound health thereafter. hope to answer your concern. further questions are most welcomed. regards Dr Tayyab Malik