|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Acute Pyelonefritis and lombar/pelvic painFrom: Ricardo Savaris (savaris@orion.ufrgs.br)Wed May 6 18:22:53 1998
Dear Folks A 40 yo patient, Gesta 3, para 3, tubal ligation 7 years ago. LMP: 20/4/98, irregular periods, (but with 3-4 days of bleeding), arrived at my office last thursday, complaining with disuria, hematuria, fever, and malaise. Few days before, she had disuria and decided by herself to start with SMX+TMP per 3 days, but it did not resolve her problem. So she went to me with the complains above mentioned. I interned her at the hospital, ordered urine analises, FBC, urine culture, and after that, start with Ampiciline 4g/day and Gentamicine 240 mg/day. Unfortunately the nurse started the antibiotics before colecting the urine sample... Physical exame: Subchronic Bartholinites on the left side, no tenderness on cervical motion No palpable adnexal mass The lab was Creatinine: 0,41 FBC: no infection on the hemograme, Hb: 9,8 She is on 6th day of Antibiotic, no fever since then, but she has complaining of pelvic and lombar pain since the very first day. It has diminished a little bit, but it still there. I have using non steroid antiinflamatory drug and codeine+dipirone (IM, if necessary) with minimal relief. The nephrologist said that I should keep the treatment as it is, but the pain still bothers me. I asked other exames according to the nephrologist suggestion: Urine analysis (after the 3rd day): 20 leuk/field, the rest was normal. US of the urinary tract: normal RX of abdomen: presence of a mass on the right side of the pelvis, the radiologist suggested CT scan CT scan: kidneys, and urinary tract are normal pelvis: presence of an enlarged uterus with miomas, they suggested a TVUS I ordered TVUS today. Questions 1. Any idea about this pain? 2.How long should I keep the antibiotic treatment? After the hospital discharge, should I give some antibiotics? Which one? Thanks,
-- Ricardo Savaris, MD, TEGO, MSc Porto Alegre, Brazil 55 51 3301354
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:24:13 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.