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Urology (Expert Forum)
Kidney Infection?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Kidney Infection?
by mickmouse, Jun 07, 2006 12:00AM
Last week, my mother was diagnosed with a urinary tract/kidney infection (blood in urine, low-grade fever (not over 100), positive urinalysis, sent for culture and we were told it returned positive for E. Coli). Macrobid prescribed. Today, her temperature (which had been normal since the day of diagnosis) has suddenly increased to a high of 103, but it has varied throughout the day from 99.6 to 103 and now down to 100.
The doctor was called and changed her medication to Cipro 500mg bid; he told her that there were three different bacteria in the culture and is sending her for a CT scan to check for stones.
My biggest immediate concern is that my mom has only one kidney; the other kidney was removed due to cancer over 40 years ago.
My questions are as follows, especially given that the first medication appears not to have worked:
1. Is the likely situation that what started out as a UTI is now a kidney infection?
2. As she has only one kidney, what kind of concern is there that a kidney infection could cause substantial harm to the kidney? Is there something we should be doing that we are not doing?
3. Should we be concerned about any blood infection/sepsis as the initial medication didn't seem to work?
4. Is it likely that the three types of bacteria in the culture are actually all part of the infection or are two of them contaminants? (It's my understanding that the urine she provided for the urostix/dipstick urinalysis was then transferred into a tube and sent off for culture).
Thank you.
The doctor was called and changed her medication to Cipro 500mg bid; he told her that there were three different bacteria in the culture and is sending her for a CT scan to check for stones.
My biggest immediate concern is that my mom has only one kidney; the other kidney was removed due to cancer over 40 years ago.
My questions are as follows, especially given that the first medication appears not to have worked:
1. Is the likely situation that what started out as a UTI is now a kidney infection?
2. As she has only one kidney, what kind of concern is there that a kidney infection could cause substantial harm to the kidney? Is there something we should be doing that we are not doing?
3. Should we be concerned about any blood infection/sepsis as the initial medication didn't seem to work?
4. Is it likely that the three types of bacteria in the culture are actually all part of the infection or are two of them contaminants? (It's my understanding that the urine she provided for the urostix/dipstick urinalysis was then transferred into a tube and sent off for culture).
Thank you.
Doctor's Answer
by Kevin Pho, MD, Jun 07, 2006 12:00AM
, Jun 07, 2006 12:00AM
To answer your questions:
1) That is certainly a possible scenario. An ascending urinary infection can lead to a worsening of symptoms, including a markedly high fever.
2) If the infection is not appropriately treated, the possibility of more severe kidney damage rises with time. Changing to Cipro is a good start. Ensuring that the bacteria is sensitive to the antibiotic should also be done (i.e. via culture and sensitivity tests).
3) Yes, if the bacteria is resistant to Cipro, there is the possibility that it can spread to the blood and cause sepsis.
4) Can't say without looking at the culture report. In general, the lab would be able to comment on the possibility of contaminant.
These questions can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
1) That is certainly a possible scenario. An ascending urinary infection can lead to a worsening of symptoms, including a markedly high fever.
2) If the infection is not appropriately treated, the possibility of more severe kidney damage rises with time. Changing to Cipro is a good start. Ensuring that the bacteria is sensitive to the antibiotic should also be done (i.e. via culture and sensitivity tests).
3) Yes, if the bacteria is resistant to Cipro, there is the possibility that it can spread to the blood and cause sepsis.
4) Can't say without looking at the culture report. In general, the lab would be able to comment on the possibility of contaminant.
These questions can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Member Comments
by naynay179, Sep 07, 2008 05:18PM
A related discussion, Is macrobid orciprofloxacin good for a kidney or bladderinfection was started.
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