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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Paraplegia, Rising Temperature, UTI. On Antibiotics. Urine Test Done And Chest X Ray. What Is Wrong?

My father is65yr old,paraplegic since 25yrs.,has multi drug resistant uti since then,off n on on antibiotics.recently developed evening rise in temp for more than one month,burning sensation at night,dry cough.has been on i'v antibiotics fr last 5 days but no reduction in fever.plain urine exam normal,culture shows uti fr which he is taking i'v antibiotic,urine Afb normal.chest X-ray normal.kindy advise.
posted on Sun, 13 Oct 2013
Twitter Tue, 15 Oct 2013 Answered on
Twitter Wed, 16 Oct 2013 Last reviewed on
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Neurologist,  's  Response
Hi,
Thank you for posting your query.
Recurrent urinary tract infection (UTI) in your father can be explained by neurogenic bladder that may have happened because of spinal cord injury. In a neurogenic bladder, there may be incomplete evacuation of bladder with residual urine after evacuation, which predisposes to recurrent UTIs.

The first issue here is to treat the current infection, which can be done by using broad spectrum antibiotics.

Second and more important issue to prevent UTIs from occurring in the future. This can be done by using antibiotics as prophylactic agents. In addition, clean intermittent catheterisation (CIC) may be taught to the patient, which can alleviate the problem of incomplete evacuation.

I hope it helps.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
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Paraplegia, Rising Temperature, UTI. On Antibiotics. Urine Test Done And Chest X Ray. What Is Wrong?

Hi, Thank you for posting your query. Recurrent urinary tract infection (UTI) in your father can be explained by neurogenic bladder that may have happened because of spinal cord injury. In a neurogenic bladder, there may be incomplete evacuation of bladder with residual urine after evacuation, which predisposes to recurrent UTIs. The first issue here is to treat the current infection, which can be done by using broad spectrum antibiotics. Second and more important issue to prevent UTIs from occurring in the future. This can be done by using antibiotics as prophylactic agents. In addition, clean intermittent catheterisation (CIC) may be taught to the patient, which can alleviate the problem of incomplete evacuation. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist