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Re: Acute Pyelonefritis and lombar/pelvic painFrom: Douglas Krell MD (dougkrell@roadrunner.com)Wed May 6 21:53:48 1998
>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. >
> I doubt that her pelvic and lumbar pain are due to the urinary tract infection. Usually pyelonephritis results in costovertebral angle tenderness, not lumbar/pelvic pain. Certainly this pain may be coming from her uterus.
>2.How long should I keep the antibiotic treatment? I would have stopped it after being afebrile for 72 hours. If infection were to reoccur, it could be cultured and and retreated according to the antibiotic sensitivities.
-- Douglas Krell MD
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