How to treat an anxious patient with a UTI?

Hello doctor,

I recently got back from holiday and started having a burning feeling and a sense of fullness in my bladder, along with needing to urinate often for the past ten days. A test showed I have a urinary tract infection, so I began antibiotics today.

I had trouble swallowing the second capsule because I have a history of aspiration, so I decided not to take it. I have another test scheduled for tomorrow.

Today, I also had a migraine and some nausea, which I have experienced before. I am worried about my UTI and would appreciate some reassurance. I have attached my test report for your review.

My doctor said the UTI is not serious, but did not tell me which capsule to take. Given this, do you think I will recover fully? I plan to take the new tablets for three days as prescribed.

Can you let me know the best time to take them and if I should expect any side effects?

Kindly help.

Thank you very much for your guidance and support.

Hello doctor,

Thank you for the reply,

I vomited, so I stopped taking it. My sensitivity test only shows certain antibiotics, and I am allergic to Penicillin. Is it possible that I can take the tablet Doxycycline or Trimethoprim?

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I will attach my culture and sensitivity test again, done two days ago. I started taking the tablet Nitrofurantoin, but had migraine and vomiting, so I stopped taking it.

I took the Trimethoprim suspension of 20 ml twice daily for five days. I am very worried because I am not noticing any improvement yet.

My nausea is back. I could not sleep and kept urinating. Also, I am nervous because my report shows I am sensitive to Trimethoprim.

I took 20 ml in the morning and evening, but I still feel this way and am worried that I am antibiotic-resistant. Is it normal not to notice change yet? My concern is that I constantly have nausea, and I am also having mild pain in my back.

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I have a new report to attach. It came back yesterday. So I shall attach it. It says everything looks clear, and all tests are negative, but show some amount of blood in the urine.

• Does it mean there is blood in my urine? I am feeling slightly better today and do not have much nausea.
• I have a burning sensation. Do you feel, based on this, that the medication is working?

I took the last dose a few days ago. I am told to take another one after the dose is finished.

Please help.

Thank you.

Hello doctor,

Thank you doctor for the reply,

I will start eating cranberries from today. I also ordered D-Mannose powder. My doctor wants me to finish it. I just took my morning dose, but I got distracted. I have taken three to four doses. Will this affect the result? I am just a bit worried because I still have symptoms. I have a burning sensation sometimes but ironically, not when urinating. My bladder feels full still. I am nervous that I have got antibiotic resistance. Is there a blood or urine test to detect resistance? I am hoping it is not. What is your view on that?

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I got the culture result from the other day so I will attach it. It says all clear.

What about my red and white blood cell range? I am still on the Trimethoprim antibiotic. I am nervous.

Is it safe to add an extra dose? I am going to undergo another vitamin test. I am really worried.

Should I undergo the DNA sequencing test? Also, I would not do those strips again; as you say, I hope this resolves. I am worried I will develop resistance as I took nine Doxycycline capsules last year.

I also took the tablet Nitrofurantoin. Is there a test for antibiotic resistance?

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I wanted to update you. I finished my liquid antibiotics. By Friday afternoon, I felt better. But Sunday evening, I had bladder fullness with some burning sensation.

So I did other culture tests like we previously discussed. I sent this off yesterday morning. It says it is satisfactory, but I am worried about the hidden bacteria.

• Why do I have these symptoms?
• What are these epithelial cells?
• Could you tell me your views?

This is because the white blood cells do not come down, as far as I know. I have been drinking organic unsweetened cranberry juice mixed with water. Please suggest something. I took a complete blood count test this morning. I have attached two pictures of the test.

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I never get UTI, and I do not remember the lingering symptoms.

Do you think this infection can go undetected?

Is the white blood cell count in that test high or normal?

I cannot understand the readings exactly. I have a full blood count coming soon this week from a normal blood test. I do not have a burning sensation while passing urine. I hope this is not scarring tissue or damage that would lead to some permanent condition.

I do not have any history of issues like this. I will leave off any invasive things for now and see how I do in the next two weeks. Is drinking cranberry juice alright? I do not see how I can end up with something chronic from this.

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I am writing you again for your professional opinion and expertise on this. Since we last spoke, I have done other cultures. Again, it shows much of the same. The doctor said it will always be showing on their testing system.

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

Can you look at the test strips given by my doctor? I constantly have blood in my urine. I do not believe this is IC. I have never had issues before. I am booked to see a specialist professor who treats embedded UTIs in two weeks.

I also did an advanced PCR-type broth test this morning and sent it off. I hope I do not have an embedded UTI. Can you advise me on what you think of all that? Of course, blood also always shows up.

Lately, I have not had many symptoms. My original symptom was frequency only. Then, I took the tablet Trimethoprim for five days. I do not know how I am going to manage to treat this. I have had relief lately because my symptoms tend to go.

The blood in the urine is always so strong. I thought it was improving. I have a burning sensation on the side near the rib and back on the right side, odd back aches, and sometimes the bladder area or pelvis has mild shooting pain.

A doctor decided to offer me the tablet Nitrofurantoin so that I could tolerate all this. I took 100 mg initially because I was scared that it was an embedded UTI.

My symptoms seem to get better. But there always seems to be some sensitivity or tenderness, which makes me aware of my bladder. I have not urinated often, but I drink more. Should I stop taking the medicines?

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I have some updates for you, so I will add some photos. My doctor thinks my culture is showing normal WBC and RBC count. He also says that everyone's report is like that. You told me that it was not normal and that I should have been on antibiotics.

Sadly, in my country, they only give us three to five days. Anyway, I need your advice. I recently did a much higher advanced culture, which has proven that it is a UTI. My original culture report did not suggest anything. This urine test showed an enterococcus species. It also says the original antibiotic to treat it is Trimethoprim. So why did my doctor say that it is sensitive? I think they still need to do tests.

So based on this information, I consulted a urologist. This urologist ultimately acknowledges embedded infection. Based on the report, he tells me that I should take the tablet Doxycycline because it is sensitive. Also, I had taken this before, but had no side effects. I am allergic to penicillin.

Would this be alright? My urologist tells me he wants me to take Doxycycline for four weeks in the morning and evening. I asked my urologist about the calcium oxalate crystals. He does not think I have stones, but recently I've had some pain.

So, based on all this, do you think it is best to go with my treatment plan with a urologist? What will happen if I do not get the sensitivity report? I have been drinking freshly squeezed lemon juice in water to avoid further issues. Also, lately, sometimes I have lower back pain. I am worried that the bacteria might be found in my vagina. Please let me know your thoughts on this and if this is the right track. My urologist told me that I should be alright even if I have an embedded UTI.

Please help.

Thank you.

Hello doctor,

Thank you for the reply,

I truly appreciate it. I cannot take Azithromycin or Gentamicin as it causes ototoxicity. What worries me is that the Acinetobacter seems to be a superbug, and I am unsure how I got it.

My first culture ever showed Coliform species, Klebsiella oxytoca, which only now shows vaginally. I am on day four of Doxycycline, but my ears are ringing more, and I have mouth ulcers.

I have taken the tablet Nitrofurantoin. Do you think it is all right to change the tablets? Will it cause resistance after three days? I am still not seeing results. Can you advise me whether I should use pessaries to kill bacteria? I recently had pelvic pain and am worried that the bacteria have spread to my reproductive organs.

Please help.

Thank you.