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Dear Ask The Doctor: 'I am in the hospital right now been here for 3 days with what started as a possible complicated UTI. I have had a fever for 3 days ranging 38-39. Red and White Blood Cells in urine and I have what they are calling a complicated bacterial infection in my blood which they have been treating my with high doses of vancomycin. I have a history of chronic kidney stones and infections but this is much worse than any other experience. Last diagnostic imaging showed that I had just passed a stone 2 days prior to my hospital stay. Specifically, last week I had two 3mm stones that showed up on a ct scan and tuesday of this week I passed a very large blood clot and two days latter I was hospitalized. Overall my condition has remained the same. Fevers spiking and breaking 3-4times daily body shakes and semi-hallucinations while sleeping and fever is high, naseau , severe flank pain in left side located in same area as would be expected for a kidney stone,overall body ache worse than that of a typical flu body ache, blood in urine, full body edema,(probably from the 5 bags of fluids a day), headaches, blurred vision and severe fatigue. I am being treated with the Vancomycin 1250 mg IV every 8 hours, Dilaudid 2mg oral prn evry 4 hours, 500 mg tylenol evry 8 hours, Zofran PRN every 6 hours. I am a 40 year old male 6 foot 2 230 lbs. Overall in general good health. I would like to know what these symptoms may be a sign of other than just a generally explained "routine" kidney infection. I am wondering if while I am here I should be checked for something else '.
Dear Robert: Most kidney stones ≤4 mm in diameter pass spontaneously. For stones larger than 4 mm in diameter, there is a progressive decrease in the spontaneous passage rate, which is unlikely with stones ≥10 mm in diameter. Kidney stones can be composed of mainly calcium, urate, struvite or cystine. Approximately 80% of patients with kidney stones form calcium stones, most of which are composed primarily of calcium oxalate or, less often, calcium phosphate. The other main types include uric acid, struvite (magnesium ammonium phosphate), and cystine stones. Analysis of the stone is an essential part of the evaluation because you may need to be tested for certain medical conditions that predispose to stone formation. From the symptoms you describe you may have an episode of pyelonephritis. A mid-stream urine sample and blood culture sample is required for culture and sensitivity of organisms, and antibiotic treatment should be tailored according to the cultured organism. Consult your urologist for advice specific to your case. |
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