URINARY TRACT INFECTION

accha ACCHA Chief Complaints A 14 y/o girl c/o frequent buring micturation & slight LBP. .. since over a past 15 days. No h/o. Fever , nausea , vomiting , chills Sometimes had h/o sore throat - STILL AFTER ANTIBIOTICS & treatment patient c/o. Burinng micruratin &. Yesterday one episode of HEMARURIA. Pls advise the diagnosis Physical Examination On examination. Patient was fine no abdominal tenderness were noted , Abdomen p/a. - soft Eyes - normal Conscious No other abnormalities were seen Investigations Investigation Cue. - normal Urine c/s. - 1st. - PSEUDOMONAS AEROGINOSA - treated with CIPROFLOXACIN 500mg bd for 10 days - URINE C/s -2nd - ENTEROCOCCUS FEACLIS. - treated with. LINEZOLOD 600mg BD 7 days Vitals Bp :- 117/74 Sp02. :- 99% hr. :- 87 Management Plss advise further approach & MANAGMENT DIAGNOSIS. .... hematuria ? One episode only

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Both Enterococcus and Pseudomonas are sensitive to Levofloxacin Adv T. Levofloxacin 500 mg one tablet daily for 7 days USG KUB to look for post void residue, as high post void residue can perpetuate urinary tract infection

Yes doctor thank you Soo much for valuable opinion These. Pseudomonas & enterococcus. Are treated with Abx But still patient c/o. Burning micturation & yesterday a episode of HEMATURIA.
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AS PER URINE C AND S..EXAMINATION .. NEED'S .. LEVOFLOXACIN .. 500 MG ..DAILY .. X 7DAYS .. INVESTIGATE WITH .. KFT .. USG..ABDOMEN PELVIS .. KUB ..

14/F..case of recurrent UTI. symptoms signs shows lower urinary tract dysfunction. incidence of UTI in females more than boys colonization of periurethral mucosa from bowel flora due to shorter urethra. variation in perineal anatomy can cause too. macroscopic haematuria can be due to calculi/diverticulum. from above organism urine looks to be in alkaline pH. other in short causes; cystitis-vaginal flora-urethritis- bowel bladder dysfunction functional disorder-VUR Ptn may require following investigation: USG full abdomen with retrograde cystography. urine R/M. Advise: -long term prophylaxis is required in such cases. -Refer the case to urologist.

Thanks for ur appreciation Dr Mir Kashif Ali..
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May be you would have offered injectable antibiotics like Piptaz 4.5 8 hourly along with Levofloxacin 100 ml 24 hourly Secondly, get a KFT and USG KUB done too

Valuable opinion
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Urine routine ultrasound lower abdomen amoxy oflacin wouldhave better

Thank you doctor
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Complete urinalysis Urine C/S after results of reports start treatment at least for 21 days

CT KUB ,CBC, ESR, CRP ,SR CREATININE urine both USG (A+P)

Thank you doctor
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Kub Levofloxacin 500 (1_0_1)for 7 days

Need Hydration, USG(A+P) Add liquid Alkalizer with antibiotics

Thank you doctor
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