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Q. From the attached urine reports, please explain the reason for weakness and raised RBC.

Answered by
Dr. Pratik Patil
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 15, 2021

Hi doctor,

My mother is in a very weak condition. I am attaching the urine test reports. Please analyze her urine test results. We are especially concerned about the high RBC count. Please explain. Thanks.

#

Hi,

Welcome to icliniq.com.

I went through the reports (attachments removed to protect the patient's identity). This is a urinary tract infection. Is she diabetic? Any other history of medical conditions? Is she taking any other medicines? It looks like she has a heavy infection load. I would suggest you send her urine for culture and sensitivity tests. Also, she can take a tablet of Ofloxacin 200 mg twice daily, tablet Metrogyl 500 mg (Metronidazole) thrice daily, tablet Nifty 100 mg (Nitrofurantoin) twice daily, and syrup Alkasol (Disodium Hydrogen Citrate) 15 ml in a glass of water thrice daily. All for five days. We will change the antibiotics as per her culture sensitivity test report. Also, make sure her blood sugar levels are strictly controlled. Check her random blood sugar levels. If she has a fever, she can take a tablet of Crocin 650 mg (Paracetamol) whenever needed. Thanks.

Hi doctor,

Thanks for the reply.

She is extremely weak. She used to have a hernia, but now the lump has disappeared. Is there any link between blood RBC count the hernia (bursting of the hernia)? Is it possible? How abnormal is the RBC count exactly? I am afraid of internal bleeding. Also, the urine flow is very little or non-existent. Only the pus and blood are dominant. The nurse had to extract them with the tube. She is very dehydrated and also has difficulty swallowing. She has constipation for two weeks. I am afraid to transport her to a hospital. If she tests COVID-19 positive, she may have a problem returning home because, in our residential complex, they will not allow a COVID-19 positive patient. So please help.

#

Hi,

Welcome back to icliniq.com.

Blood in the urine is common in urinary tract infections. The second possibility can be a bleeding vessel somewhere in the bladder, diagnosed by an ultrasound scan of the abdomen. We can do a CBC (complete blood count) weekly and see if the hemoglobin is dropping. If it is declining, there can be significant bleeding, for which we will need further investigation. Urine flow is negligible because of dehydration. If there is a nurse, she can give normal saline by IV (intravenous) drip at 80 cc per hour. Also, give all kinds of juices and drinks, oral rehydration solution (ORS), and plain water orally as much as possible. Difficulty swallowing is also because of dehydration. You can give syrup Cremaffin (Paraffin and Milk Of Magnesia) 30 ml orally after dinner for constipation. If stools still do not pass, increase the dose to twice daily. All her symptoms are pointing towards diabetes mellitus. Are you sure of her blood sugar levels? Please check and revert.

Hi doctor,

Thanks for the reply.

There is no history of diabetes, and we are aware of it. But can it develop with age? She is having great difficulty eating food as well. The problem started three months ago with pain in her stomach. She has a long IBS history, so we thought it to be gas pain. Recently we tried 10 ml of Dufalac medicine. But there was no effect. Instead, the pain increased. She also has a fear of passing away. She is unable to eat much food at all. For one and a half weeks, her weight is going down fast. I have one question: the hernia lump was about tennis ball size for more than ten years and did not bother her. But now, its disappearance coincides with the more rapid deterioration of her condition in the past couple of weeks. Has anything gone wrong with that? Is that a possible explanation for the blood, pus, and very little urine flow? Also, in the hernia spot, she has pain. Can there be any internal infection at the site of the hernia burst? There is a morning nurse, and recently IV was given. Shall we continue the IV? Urine culture is being done. Is it possible to provide antibiotics IV? Will that help? Thank you for your inputs.

#

Hi,

Welcome back to icliniq.com.

Diabetes is age-related morbidity. I think she may have diabetes. Check her random blood sugar levels at home. The nurse can do it for you. Hernia cannot cause such bleeding or obstruction. Continue IV normal saline, MVI (Multivitamin Injection), one ampule IV every day, injection Elemune (L-alanyl-L-glutamine) one ampule IV every day. The nurse can do this. Also, I will suggest ultrasound of the abdomen, blood sugar random, CBC (complete blood count), KFT (kidney function test), and LFT (liver function test). These will clear the situation. Thank you.


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