Persistent Low-Grade Fever and Bacterial Infections in Urology - Urology

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Persistent low-grade fever, defined as a body temperature ranging from 36.8 to 37.5 degrees Celsius, can be a perplexing symptom, especially when accompanied by fatigue and discomfort. In the context of urological health, it is essential to consider various factors that may contribute to this condition, particularly the potential for bacterial infections.

From the details provided, it appears that you have been experiencing these symptoms since February, with a notable increase in urinary abnormalities observed during your health check-up in May. The presence of elevated creatinine (1.33 mg/dL), uric acid (8.1 mg/dL), and positive findings for urine protein, ketones, and urobilinogen, along with leukocytes and bacteria in your urine, suggests a possible urinary tract infection (UTI) or other underlying urological issues.

The medications you are currently taking, Uroprin and Doxynin, are commonly prescribed for urinary tract conditions. Uroprin is often used to manage urinary tract infections, while Doxynin is an anticholinergic agent that helps reduce bladder spasms. Despite being on these medications for nine days, your persistent low-grade fever and fatigue indicate that the underlying issue may not be fully resolved.

Several factors could contribute to your ongoing symptoms:
1. Incomplete Treatment of Infection: It is possible that the antibiotic treatment may not have fully eradicated the infection, or that the bacteria present are resistant to the prescribed antibiotics. This is particularly relevant if the urine culture has not shown significant growth, as some bacteria may not be easily cultured or may require specific conditions for growth.

2. Chronic Inflammation: Conditions such as chronic prostatitis or interstitial cystitis can lead to persistent low-grade fever and urinary symptoms. These conditions may not always present with clear bacterial infections but can cause significant discomfort and systemic symptoms.

3. Underlying Conditions: Given your elevated creatinine and uric acid levels, it is crucial to evaluate kidney function and consider other potential renal issues, such as glomerulonephritis or nephrolithiasis (kidney stones), which can also contribute to systemic symptoms like fever and fatigue.

4. Immune Response: Your body’s immune response to any ongoing infection or inflammation can manifest as a low-grade fever. This response may be more pronounced if you have underlying health conditions that affect your immune system.

5. Environmental Factors: Sometimes, external factors such as stress, changes in temperature, or even dietary influences can affect body temperature regulation and contribute to feelings of fatigue and malaise.

Given these considerations, it is advisable to follow up with your healthcare provider for further evaluation. This may include:
- Repeat Urine Culture: To check for any resistant bacteria or to confirm the absence of infection.

- Blood Tests: To assess kidney function, liver function, and inflammatory markers (such as C-reactive protein) that may indicate ongoing inflammation or infection.

- Imaging Studies: Such as an ultrasound or CT scan of the abdomen and pelvis to evaluate for any structural abnormalities in the urinary tract or kidneys.

- Specialist Referral: If symptoms persist, a referral to a urologist or infectious disease specialist may be warranted for more specialized evaluation and management.

In conclusion, while low-grade fever can be a benign symptom, its persistence in the context of urinary abnormalities warrants thorough investigation. Monitoring your symptoms closely and maintaining open communication with your healthcare provider will be key in addressing the underlying causes and achieving a resolution.