Urinary Tract Infections: Symptoms, Diagnosis, and Treatment

Q: Urinary Tract Infections: Symptoms, Diagnosis, and Treatment

Hello： <br>1. <br>What could be the reason for my cloudy urine? - If it is consistently cloudy, there may be a pathological cause. <br>If it varies, you should increase your water intake to over 2000 ml per day, especially if you are not sweating excessively. <br>Avoid sugary dri

Urinary tract infection (UTI)

Hello Doctor: I have had cloudy urine for about a month, and after undergoing an egg retrieval procedure at National Taiwan University in early April, my body temperature has been elevated, around 37 to 37.2 degrees Celsius (I usually have a lower body temperature).
I feel uncomfortable with what seems like a low-grade fever, and I have been feeling unwell every day.
I returned to National Taiwan University to see a gynecologist, where they performed a bacterial culture and prescribed antibiotics.
However, after finishing the antibiotics, the low-grade fever persisted.
The doctor mentioned that elevated body temperature is common after egg retrieval and that it should resolve with the next menstrual period.
Since the surgery, I have had two menstrual cycles, but the low-grade fever and discomfort continue.
Later, I experienced lower abdominal pain and went to Cheng Hsin General Hospital's gynecology department, where the bacterial culture indicated Group B Streptococcus, and I was told no medication was needed.
I forgot to mention the cloudy urine at Cheng Hsin, so I went to Tri-Service General Hospital to see an infectious disease specialist.
The doctor asked if I had frequent urination, to which I replied that I usually do.
I underwent a urinalysis and blood tests, and the results showed CRP <0.1 and a positive aerobic culture for Streptococcus agalactiae.

I would like to ask:
1.
What could be causing my cloudy urine?
2.
Do I need to return to the hospital for medication?
3.
What could be causing my frequent urination? Was this checked in the tests?
4.
Is the persistent low-grade fever over the past month related to a urinary tract infection?
Given the severe pandemic situation, it is difficult to go to the hospital, and I cannot find the cause of my discomfort.
I feel lost.
Thank you, Dr.
Du, for the online consultation.

nina, 30~39 year old female. Ask Date: 2021/06/05

Dr. Du Shixi reply Urology

Hello:
1.
What could be the reason for my cloudy urine? - If it is consistently cloudy, there may be a pathological cause.
If it varies, you should increase your water intake to over 2000 ml per day, especially if you are not sweating excessively.
Avoid sugary drinks.
2.
Do I need to return to the hospital for medication? - If both urine analysis and culture show abnormalities, you should take the prescribed medication and then return for follow-up testing.
3.
What does frequent urination indicate? Were there any tests conducted for frequent urination? - Frequent urination is merely a symptom; it can be influenced by inflammation, poor bladder function, food, and beverages, among other factors.
4.
Is a low-grade fever lasting for a month and a half related to a urinary tract infection? - In my personal experience, a urinary tract infection typically does not cause a prolonged low-grade fever; it usually resolves with increased fluid intake or progresses to a higher fever.

Wishing you good health.

Reply Date: 2021/06/05

More Info

Understanding urinary tract infections (UTIs) is crucial, especially for individuals experiencing recurrent symptoms. Your situation highlights several important aspects of UTIs, including symptoms, diagnosis, and treatment options.

1. Symptoms of UTIs: Common symptoms include frequent urination, a burning sensation during urination, cloudy or foul-smelling urine, and lower abdominal pain. In your case, the persistent low-grade fever (37-37.2°C) and discomfort you are experiencing could be indicative of an ongoing infection or inflammation. The presence of cloudy urine can suggest a UTI, but it can also be due to other factors such as dehydration or the presence of crystals or mucus in the urine.

2. Diagnosis: The diagnosis of a UTI typically involves a urinalysis and urine culture. The urinalysis can reveal the presence of white blood cells, red blood cells, and bacteria, while the culture identifies the specific organism causing the infection. In your case, the identification of *Streptococcus agalactiae* (Group B Streptococcus) is significant. While this organism is commonly associated with infections in pregnant women and newborns, it can also cause urinary tract infections, particularly in individuals with underlying health issues.

3. Treatment: Given that you have been diagnosed with a UTI caused by *Streptococcus agalactiae*, it is essential to follow up with your healthcare provider regarding appropriate antibiotic treatment. If your doctor has advised against medication, it may be due to the organism's sensitivity or your overall health status. However, if you continue to experience symptoms, it is crucial to advocate for your health and seek further evaluation. Antibiotics are typically prescribed to eliminate the infection, and if symptoms persist after treatment, further investigation may be warranted.

4. Frequency of Urination: Frequent urination can be a symptom of a UTI, but it can also be caused by other conditions such as interstitial cystitis, bladder overactivity, or even anxiety. If your urinalysis did not indicate a significant infection, it may be beneficial to explore these other potential causes with your healthcare provider.

5. Low-Grade Fever: The persistent low-grade fever you are experiencing could be related to the UTI, especially if there is an ongoing infection. However, it could also indicate another underlying issue, such as a post-operative complication from your egg retrieval procedure. It is essential to monitor this symptom closely and discuss it with your healthcare provider, as prolonged fever can indicate a need for further investigation.

6. Next Steps: Given the complexity of your symptoms and the duration of your discomfort, it is advisable to return to your healthcare provider for a thorough evaluation. You may need additional tests, such as imaging studies or a referral to a specialist, to rule out other potential causes of your symptoms. If you are hesitant to visit a hospital due to the pandemic, consider telehealth options to discuss your symptoms with a healthcare professional.

In summary, your symptoms of cloudy urine, persistent low-grade fever, and frequent urination warrant further investigation and appropriate treatment. It is essential to communicate openly with your healthcare provider about your ongoing symptoms and advocate for the necessary care to address your health concerns.

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