Hi, I was on vacation and started to have the symptoms of a urinary tract infection: frequent urination, lower back pain and in the lower abdoment on both right and left sides. I went to the doctor, he tested my urine, and confirmed that I have a UTI. He prescribed me antibiotic for a week. I finished doing the treatment but 2 days after the symtoms returned. I went to get a refill of antibitic and was taking it for 5 days. My urination is better but I have a terrible burning pain on both left and right sides of a lower abdomen and some pain in a lower back area. I went to the urgent care today but my blood and urine tests were normal. I have a low grade fever, 37 C. What can be the cause of all of this and what other tests can I do?
Pain killers, antibiotic
you need to have a urine culture done. Sometimes urinalysis tests come back normal and are false negative.
Next, an upright KUB x-ray or ultrasound looking for kidney stones.
Now, you also have to consider it may not be a UTI..rather ovarian or bowel issues and the UTI was coincidental.
Take some pyridium or Azo and see if you get relief...if you do, it is definitely urinary tract related...if no relief you need to have your doctor start looking elsewhere (ie. ovaries with ultrasound, etc).
I'm happy to answer follow up question as needed, but remember to click 'accept'.
thank you so much,Dr. Pfeiffer
Thank you for your reply. I have several follow up questions. Since I am taking antibiotic, does it make sense to do a urine culture?
I did take azo and it helped to relieve my syptoms for 1-2 h after I took it. But I already used all of it and it seems like I should not take it for more than 2 days.
Is it possible that I had a bladder infection that made its way to kidneys. Will ultrasound be enough to diagnose it?
yes - urine culture is very important and is to prove that whatever is causing your infection is sensitive to the antibiotics...so, if anything were to grow out, it is resistant to the antibiotic you are on.
Next, if the azo helped keep taking it. The 2 day limit is for people who are not under a doctors care and simply take it to feel better. In this way it is saying if you are not feeling better or need to keep taking it after 2 days...you need to see a doctor. So, don't be miserable, but certainly call your doctor in the AM.
Yes, it is possible this is pyelonephritis (kidney infection) and you might benefit from IV antibiotics.
An ultrasound will only help show if there is obstructive uropathy and occasionally a kidney stone. an ultrasound will not show pyelonephritis.
I'm happy to answer follow up questions as needed, but remember to click 'accept'.thank you so much.Dr. Pfeiffer
Thank you for your reply. If this is pyelonephritis, how can it be diagnosed? Is a lower grade fever (37 C) and indicator of inflammation of any kind?
usually there is bilateral or unilateral flank pain, fever, elevation of the WBCs on a blood count...but, if you are on antibiotics it may have suppress these reactionary processes by the body.
So, I would really get a urine culture and probably IV or IM rocephin (1g) in addition to anything else you might be taking (assuming cipro).
You are right I am taking cipro. After I do the culture and take an additional dose of antibiotic, should I still consider other possibilities you mentioned and proceed with ultrasound and X-rays?
Yes...if you have continued symptoms.
Hopefully they go away though.