Hematuria and Fever: A Guide to Urological Concerns

Q: Hematuria and Fever: A Guide to Urological Concerns

Hello： It is most likely that you have kidney stones accompanied by a urinary tract infection, so you need to take medication and drink plenty of water. <br>There is hydronephrosis in the left kidney, which may be due to stones (size may vary), causing a slower recovery from the

Hematuria with fever

As soon as I noticed blood in my urine, I went directly to a large hospital for evaluation.
After the doctor performed a urinalysis, they prescribed me a 5-day course of antibiotics.
That night, before bed, I developed a high fever of 38.8 degrees Celsius.
I took some antipyretics that I had at home.
The next day, I woke up and the blood in my urine and frequent urination had resolved, but my temperature was still around 37.5 degrees Celsius.
Since the hospital only provided me with antibiotics, I went to a pediatric clinic to obtain some gastric medication and anti-inflammatory pain relievers to take together.
My temperature briefly returned to normal, but soon it went back to around 37.5 degrees Celsius.
During the New Year holiday, after completing the 5-day course of medication, I went two days without any medication.
Since my temperature was still around 37.5 degrees Celsius and had not fully returned to normal, I returned for a follow-up appointment on the fourth day of the New Year.
The substitute doctor assessed that my urinalysis results were normal and speculated that my right kidney was functioning properly, but my left kidney had stones and was experiencing hydronephrosis.
The stones might be obstructing the urinary tract, causing inflammation and fever.
They initially planned to schedule a CT scan for me, but due to scheduling conflicts at the hospital, they asked if I wanted to proceed with surgery if it was urgent.
I was taken aback; the cause of the fever had not yet been determined, and there was no clear diagnosis for the condition, so how could I consider surgery? The doctor then arranged for me to have a CT scan at a partner hospital.
After my follow-up appointment, I continued taking the 6-day course of antibiotics prescribed by the follow-up doctor, and I plan to have the CT scan in two days.
Currently, it is the eighth day of my illness, and my temperature remains around 37.5 degrees Celsius.
What should I do, doctor?

Xiao Fen, 40~49 year old female. Ask Date: 2019/02/08

Dr. Du Shixi reply Urology

Hello: It is most likely that you have kidney stones accompanied by a urinary tract infection, so you need to take medication and drink plenty of water.
There is hydronephrosis in the left kidney, which may be due to stones (size may vary), causing a slower recovery from the infection.
After undergoing a CT scan, it can be determined whether surgery is necessary (small stones may pass on their own).
Additionally, be aware of any other symptoms, as there may be other issues causing the fever as well.
Therefore, continuing to take medication, drinking plenty of water, avoiding spicy foods, not holding in urine, and paying attention to your body's condition are currently the most feasible approaches.
Wishing you good health.

Reply Date: 2019/02/08

More Info

When dealing with symptoms like hematuria (blood in urine) and fever, it is essential to understand the potential underlying causes and the appropriate steps to take for diagnosis and treatment. Your situation raises several important points that warrant further discussion.

Firstly, hematuria can be caused by a variety of conditions, including urinary tract infections (UTIs), kidney stones, trauma, or even more serious conditions like tumors or glomerulonephritis. The presence of fever, particularly a high fever like 38.8°C (101.8°F), often indicates an infection or inflammation in the body. In your case, the initial treatment with antibiotics suggests that your healthcare provider suspected a UTI or another bacterial infection.

The fact that your hematuria and frequent urination resolved after starting antibiotics is a positive sign, indicating that the initial treatment may have been effective. However, the persistence of a low-grade fever (around 37.5°C or 99.5°F) suggests that there may still be an underlying issue that needs to be addressed. It is not uncommon for fevers to linger even after the primary symptoms have improved, especially if there is an ongoing inflammatory process or if the infection has not been completely eradicated.

Your follow-up with a pediatrician and the subsequent referral for a CT scan is a prudent step. The concern regarding kidney stones and hydronephrosis (swelling of a kidney due to a build-up of urine) is particularly relevant. If a stone is obstructing the urinary tract, it can lead to infection and inflammation, which could explain both your fever and hematuria. The CT scan will help visualize the urinary tract and identify any stones or other abnormalities that may be contributing to your symptoms.

In the meantime, it is crucial to monitor your symptoms closely. If you experience any worsening of your condition, such as increased pain, changes in urination, or a significant rise in fever, you should seek medical attention immediately. Additionally, ensure you stay well-hydrated, as this can help flush out the urinary system and may alleviate some symptoms.

Regarding your concern about the possibility of surgery, it is understandable to feel apprehensive, especially when the cause of your fever has not been definitively identified. Surgical intervention is typically considered when there is a clear indication, such as a large stone causing obstruction or severe infection that does not respond to conservative treatment. It is essential to have a thorough discussion with your healthcare provider about the risks and benefits of any proposed procedures, and to ensure that all non-invasive options have been explored first.

In summary, your situation requires careful monitoring and further investigation. Continue taking the prescribed antibiotics as directed, and prepare for your upcoming CT scan. Keep an open line of communication with your healthcare providers, and do not hesitate to ask questions or express concerns about your treatment plan. Understanding the potential causes of your symptoms and the rationale behind your treatment will empower you to make informed decisions about your health.

Similar Q&A

Understanding Hematuria: Causes, Symptoms, and When to Seek Help

A few years ago, I had pyelonephritis and experienced a high fever of 39 degrees Celsius. After the fever subsided, I discharged myself from the hospital, but I'm unsure if I fully recovered. In recent years, health check-ups have consistently shown the presence of hematuria...

Dr. Song Zhixian reply Urology
A detailed examination should be conducted based on the condition, including contrast pyelography, ultrasound, and cystoscopy to rule out any congenital abnormalities, stones, or tumors. If all of the above are normal, regular follow-up is still necessary. If hematuria is present...

Understanding Hematuria in Children: Causes, Concerns, and Next Steps

Hello: My son is four years old and four days ago he had a sore throat with inflammation and fever, for which he received medication. Later, he experienced pain during urination, and after going to the hospital for a urine test, it was found that there was hematuria (blood in uri...

Dr. Tu Xiuhong reply Urology
Hello Margaret: Your son is experiencing pain while urinating, which may indicate a urinary tract infection. Symptoms such as a cold, fever, and urinary tract infection can all lead to hematuria (blood in urine). It is advisable to take your son to the hospital for a medical eval...

Understanding Hematuria and Urinary Symptoms: A Urology Perspective

Hello, For the past two months, I have been experiencing frequent urination (with a sudden and urgent need to urinate) and difficulty urinating. I have visited the doctor multiple times for urine tests, which did not show any bacterial growth, but the results indicated 2+ occul...

Dr. Du Shixi reply Urology
Hello: If there is still a fever, it is important to check the culture results and investigate if there is an infection in other areas. As for sudden extreme hunger and dry mouth, it may be a side effect of the anticonvulsant medication. If the fever persists, hospitalization for...

Managing Recurring High Fever and Urgency: A Urology Perspective

Due to work commitments, I am currently in Germany and will not be able to return to Taiwan for about two weeks. I would like to consult a physician regarding emergency measures and follow-up procedures. Ten years ago, I experienced symptoms such as hematuria and frequent urinati...

Dr. Zhang Chengye reply Urology
Possible cystitis with acute nephritis; urine tests should be conducted for confirmation before initiating antibiotic treatment. Refer to urology or infectious disease specialists. The patient reports symptoms of frequent urination and fever.