Blood in Urine After Fever: Causes and Concerns - Internal Medicine

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Hematuria after fever?


Dear Dr.
Yang, I have recently experienced a fever accompanied by decreased urine output and dark brown urine.
This situation also occurred once last year.
I am wondering if it is related to medication.
Can "line virus" also cause hematuria, and is this symptom serious? Thank you for your clarification.

Mr. Zhan, 30~39 year old female. Ask Date: 2004/05/13

Dr. Yang Jun reply Internal Medicine


Hello: In response to your question, it is mentioned that decreased urine output after a fever may be due to increased fluid loss through sweating or reduced fluid intake, leading to a lower volume of fluid excreted by the kidneys and consequently decreased urine output.
As for the urine appearing brown, it may be caused by hematuria or hemoglobinuria.
A urinalysis is necessary for differential diagnosis.
Some medications may cause changes in urine color, so it is important to inform the physician about any current medications to aid in differentiation.
It is rare for viral infections to cause hematuria; most cases are due to bacterial infections leading to hemorrhagic cystitis or acute pyelonephritis resulting in hematuria.

Reply Date: 2004/05/13

More Info


When experiencing symptoms like reduced urine output and dark brown urine following a fever, it is crucial to understand the potential underlying causes and their severity. The symptoms you describe can be indicative of several medical conditions, and it is essential to consider them carefully.

Firstly, the reduction in urine output during a fever can often be attributed to dehydration. When the body is fighting an infection, it may lose fluids through sweating, and if fluid intake is not adequately maintained, this can lead to decreased urine production. Additionally, fever can cause the kidneys to conserve water, further contributing to lower urine output.

The dark brown color of the urine raises concerns about the presence of blood (hematuria) or myoglobinuria, which can occur due to muscle breakdown. It is essential to differentiate between these possibilities through urinalysis. Blood in the urine can be caused by various factors, including urinary tract infections (UTIs), kidney stones, or more severe conditions such as glomerulonephritis or bladder infections.
Regarding your question about medication, certain drugs can indeed alter urine color. For instance, some antibiotics or medications used to treat infections may cause urine to appear darker. Therefore, it is vital to inform your healthcare provider about any medications you are currently taking, as this information can help in diagnosing the cause of your symptoms.

As for the "line virus" you mentioned, if you are referring to a specific viral infection, it is worth noting that while most viral infections do not typically cause hematuria, some can lead to complications that might affect the urinary system. For example, viral infections can sometimes lead to secondary bacterial infections, which could result in symptoms like hematuria. However, it is relatively uncommon for viral infections to directly cause blood in the urine.

The severity of your symptoms should not be underestimated. Blood in the urine, especially when accompanied by fever and reduced urine output, warrants immediate medical evaluation. It is essential to rule out serious conditions such as kidney injury or severe infections that could lead to complications if left untreated.

In summary, the combination of fever, reduced urine output, and dark urine is concerning and should prompt further investigation. A urinalysis is a critical first step in determining the cause of your symptoms. Depending on the findings, additional tests such as imaging studies or blood tests may be necessary to identify any underlying issues. If you experience worsening symptoms, such as increased pain, persistent fever, or any other alarming signs, seek medical attention promptly. Your health and well-being are paramount, and timely intervention can make a significant difference in outcomes.

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