Update to : Worried about DD

oh my, poor thing, I have to say at this point I would be considering
requesting hospital admission and getting the extra test done in parallel
with IV antibiotic treatment. You say she is not in pain, but how long will
she not be in pain for? It may be that a 24hr ish hospital admission, 4
doses IV antibiotics will give them a chance for everyone to talk to the
right people and see her leaving hospital quite soon with the right oral
antibiotics. You don't always have to have a full course in hospital, I once
had a 24hr admission for IV antibiotics, then went home on a hefty dose of 2
at the same time.

Anne

Lara writes:

As far as I know, cranberry juice is only useful for common or garden
variety E.coli UTI. Pseudomonas UTI is a completely different ballgame.
I'm kinda amazed the docs are procrastinating on this without an ID
consult. I hope things will work out for you (the OP) soon. You might
need to be pushy, go to an ED, insist on an ID consult, etc.

Do you actually know this? I'm not sure, but since the mechanism is that
something in the cranberry juice stops the bacteria sticking to the
bladder walls so easily, basically, it seems more natural to think that it
would work for any kind of bacteria. However, I certainly *wouldn't*
advocate doing cranberry juice instead of anything - rather, doing it as
well as everything else you can think of. I too would be very unhappy with
the delay in this case.

Sidheag
DS Colin Oct 27 2003

"CY" wrote in message
news:iDBbf.550742$xm3.512722@attbi_s21...
Sorry to post here, but I just need to write it down...somehow it doesn't
seem scary if I do that!

You're probably going to reach out and bitchslap me for this, but-breathe.
Calm. Or make a reasonable facsimile thereof. Make some tea/hot
chocolate/fruitilicious rum drink, take a hot bath and breathe.

If it were urgent, the doctor would have admitted her tonight. Overnight
ATPIT isn't going to make a significant difference. If she starts passing
out from the pain, that's another story-but she's not. He's concerned, but
he doesn't think it's serious enough to warrant a hospital visit. Just keep
that right there in the front of your mind, and remember that your DD will
be ok.

*Hugs*

Jess

Sidheag McCormack skrev:
Lara writes:

As far as I know, cranberry juice is only useful for common or garden
variety E.coli UTI. Pseudomonas UTI is a completely different ballgame.
I'm kinda amazed the docs are procrastinating on this without an ID
consult. I hope things will work out for you (the OP) soon. You might
need to be pushy, go to an ED, insist on an ID consult, etc.

Do you actually know this? I'm not sure, but since the mechanism is that
something in the cranberry juice stops the bacteria sticking to the
bladder walls so easily, basically, it seems more natural to think that it
would work for any kind of bacteria. However, I certainly *wouldn't*
advocate doing cranberry juice instead of anything - rather, doing it as
well as everything else you can think of. I too would be very unhappy with
the delay in this case.


I've always heard that it makes the environment (term?) so acid that the
bacteria doesn't thrive.

Tine, Denmark

Sidheag McCormack wrote:

Lara writes:

As far as I know, cranberry juice is only useful for common or garden
variety E.coli UTI. Pseudomonas UTI is a completely different ballgame.
I'm kinda amazed the docs are procrastinating on this without an ID
consult. I hope things will work out for you (the OP) soon. You might
need to be pushy, go to an ED, insist on an ID consult, etc.

Do you actually know this? I'm not sure, but since the mechanism is that
something in the cranberry juice stops the bacteria sticking to the
bladder walls so easily, basically, it seems more natural to think that it
would work for any kind of bacteria.

No, I don't actually know it; but there is no microbiological reason I
can think of to automatically assume that the anti-adhesion effect would
hold for all bacterial species - maybe it does, maybe it doesn't. Most
of the UTI-cranberry research has been done on fimbriated E coli,
however, in review research has been criticised for being inconsistent
and poorly designed with high dropout rates[1]. It's also really only
been studied in healthy adult women. I also can't find any positive
studies on cranberry juice in treatment, only in reducing recurrences by
about fifty percent.

A very recent study showed zero activity against one strain of
Pseudomonas [2]. A recent study has also shown no effect on urine pH[3],
though results in the past have sometimes suggested it might.

Since it's a safe option, I've nothing against the idea of trying it; I
just think it can lead to a false sense of security and risks delaying
more effective diagnosis and management.

Lara

[1] Clin Infect Dis 2004 May 15;38(10):1413-9. Epub 2004 Apr 26.
Cranberry juice and urinary tract infection.
Raz R, Chazan B, Dan M.

Cochrane Database Syst Rev 2004;(1):CD001321. [MEDLINE]
Cranberries for preventing urinary tract infections.
Jepson RG, Mihaljevic L, Craig J.

[2] J Med Food 2005 Spring;8(1):36-40. [MEDLINE]
Antibacterial screening of anthocyanic and proanthocyanic fractions from
cranberry juice.
Leitao DP, Polizello AC, Ito IY, Spadaro AC.

[3] Rev Invest Clin 2005 May-Jun;57(3):442-6. [MEDLINE]
[Does cranberry juice have bacteriostatic activity?]
Monroy-Torres R, Macias AE.

In .com,
Akuvikate wrote:

*Definitely treat it. If you let urinary tract infections linger for
*too long (ie, months) in little kids it can cause renal scarring.
*FWIW, the reason cipro isn't approved for children is that it causes
*cartilage problems in beagle puppies. Really. Most pediatricians
*suspect that it's probably fine for children, and studies that everyone

Furthermore, many board-certified veterinary internal medicine specialists
are now starting to tell us lowly GPs that "beagles aren't really dogs,"
and that it is ok to use enrofloxacin (the doggy version of cipro) in
"regular puppies" under certain circumstances

-h.

--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx

CY wrote:

I have so many questions, it's not even funny. How on earth do you get this
bacteria? She has complained of pain on urination once before, about a year
ago, but since it only happened once, I just thought it was one of those
things. I hope to God she hasn't had this for a year. If she has had it
for a while, can she be symptomless and then suddenly show (or complain of)
symptoms? If she's had it for a while. could she have renal scarring? If
she has renal scarring, what does that mean? I can't sleep for worrying. I
am scaring myself by reading a lot on the net (which I have now stopped),
but I hate this not knowing...it's killing me.

No wonder you're stressed. Sorry I didn't reply sooner; I didn't see
your post until today. I hope by now your docs have sorted themselves
out and you have more of an answer and plan of action.

As with most bacteria, Pseudomonas is just sort of around. It's most
known for infecting burn patients and cystic fibrosis patients -- I
have no idea why those specfically.

It's actually pretty routine to get a renal ultrasound and VCUG (study
for reflux of urine from the bladder into the kidneys) on little kids
with UTIs. I forget the exact guidelines but I think it's recommended
now that everyone below a certain age gets at least a renal ultrasound
if they have even a single UTI.

UTIs and renal scarring are not an area I know super-well, but I think
even if it takes a while to clear, one UTI has a relatively low
likelihood of causing it. There are kids with recurrent prolonged UTIs
and I think they're the ones who get renal scarring. There is a
nuclear medicine scan that can show it, but it's not routinely done
unless there's a real suspicion from the clinical history or the urine
tests that it might be present.

Please keep us posted when this gets sorted out.

Kate, ignorant foot soldier of the medical cartel
and the Bug, almost 2 and 1/2

Hi Kate

Thanks for your (long and helpful!) response...

It's not completely sorted out yet, but we are close. The long and short is
that the (4th) urinalysis came back negative for pseudomonas. HOw the hell
you can have 2 positive and two negative I don't know, but the (very nice,
and seasoned) pediatrician that we saw on that Saturday said that she
probably has (had) an infection on the outside but which did not reach the
kidneys/bladder. So apparently one can have some of the symptoms of a UTI
but not actually have one, hence all the confusion in this case. He tiold
me to give her Epsom salts sitz baths twice a day and to use Hydrocortisone
cream three times a day and amazingly this seems to have done the trick.
She is peeing quite frequently (about 3 times an hour) but I beleive this is
due to stress because we were telling her that she must not hold her pee and
must let it out so that she doesn't get another infection. I think once she
had that second episode of burning, it really scared her and now she wants
to go potty every time she feels the slightest urge. Doc said to keep an
eye on it, but he was not concerned at this point, that it sounded
behavioural. We still do not have the ultrasound results back, but I am
hopeful it is nothing.

SO glad I didn't give the Cipro and she didn't need to be admitted. It was
all just a storm in a teacup apparently. Thank you ALL for your support. I
really appreciate it.



CY
"Akuvikate" wrote in message
ups.com...

CY wrote:

I have so many questions, it's not even funny. How on earth do you get
this
bacteria? She has complained of pain on urination once before, about a
year
ago, but since it only happened once, I just thought it was one of those
things. I hope to God she hasn't had this for a year. If she has had it
for a while, can she be symptomless and then suddenly show (or complain
of)
symptoms? If she's had it for a while. could she have renal scarring?
If
she has renal scarring, what does that mean? I can't sleep for worrying.
I
am scaring myself by reading a lot on the net (which I have now stopped),
but I hate this not knowing...it's killing me.

No wonder you're stressed. Sorry I didn't reply sooner; I didn't see
your post until today. I hope by now your docs have sorted themselves
out and you have more of an answer and plan of action.

As with most bacteria, Pseudomonas is just sort of around. It's most
known for infecting burn patients and cystic fibrosis patients -- I
have no idea why those specfically.

It's actually pretty routine to get a renal ultrasound and VCUG (study
for reflux of urine from the bladder into the kidneys) on little kids
with UTIs. I forget the exact guidelines but I think it's recommended
now that everyone below a certain age gets at least a renal ultrasound
if they have even a single UTI.

UTIs and renal scarring are not an area I know super-well, but I think
even if it takes a while to clear, one UTI has a relatively low
likelihood of causing it. There are kids with recurrent prolonged UTIs
and I think they're the ones who get renal scarring. There is a
nuclear medicine scan that can show it, but it's not routinely done
unless there's a real suspicion from the clinical history or the urine
tests that it might be present.

Please keep us posted when this gets sorted out.

Kate, ignorant foot soldier of the medical cartel
and the Bug, almost 2 and 1/2