Doctors Lounge - Urology Answers
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Forum Name: Urology Topics
|missang24 - Tue Oct 27, 2009 9:27 am||
I am actually writing this from the hospital right now. I am at a loss of how to deal with all of this.. The last 3 months have been incredibly stressful and we have almost lost our infant son on 3 different occassions.
He has had 3 confirmed UTI's. 2 of which led to a kidney infection and ecoli sepsis. We have the pediatrician in our area doing all kinds of tests, but they just recently (since being admitted this time for sepsis) have started taking it seriously. He is referring us to a specialist out of town a pediatric urologist.
Basically my questions are :
1. I have been reading a lot about septicemia, and it's potentially life threatening especially in babies. The pediatrician after the first incident told me that he doubted that it would happen again because my son would be older and should be able to fight it off. Do you think that he should have taken this more seriously and atleast did some follow up urine tests?
2. What are complications that could develop from having 2 different episodes of sepsis? My son is only 3 months old and has had it twice now.
3. He has been placed on prophylactic antibiotics until they can get to the bottom of this. My worries are that the bacteria will become resistant to these and we could end up in more problems than we are now.
4. I'm very frustrated with the care that he has received thus far. Since the first incident, after being discharged when he was only 7 weeks old I had taken him back into emerg about 3-4 different times suspecting another UTI. One of those times he did have another confirmed UTI and was placed on oral antibiotics and sent home. The pediatrician (same one as now) almost made me feel as though I was crying wolf and made me feel very silly for continuing to bring him back. I know now that I was right and that I had every reason to worry.... What do you think about this behaviour of this pediatrician? Every day that we have been in this hospital he comes in the morning to see us and he brings about 2 med students with him and asks them a bunch of questions about everything, they are left stunned and don't know the answers and I feel as though I have gotten none of my questions answered!! I don't want my son to be used as a training device, this is serious stuff!!
I would just appreciate some advice as I am having a real hard time coming to terms with going home now. I am afraid that we wont be so lucky if it happens again.
I also wanted to mention that he has had a VCUG done w/ the first incident and it came back negative. He has also had two ultrasounds done on his kidney and bladder.... They are repeating these tests.
Its' now Day 7 of him being on IV antibiotics and they are releasing us from the hospital and to be put on oral antibiotics.. Do you think this is sufficient considering the circumstances?
It could me a month or more before we get in to see the specialist because this pediatrician wants to have all of the results back first from all of the blood tests, vcug, etc. I don't know if I can wait that long!!
|Dr.M.Aroon kamath - Sun Nov 01, 2009 8:59 am||
Firstly i empathize with you regarding the problems you are enduring.
It is rather unfortunate when something goes sour in a "doctor-patient" relationship.
It appears that the pediatrician regularly visited your child ("Every day that we have been in this hospital he comes in the morning to see us"), is interested in teaching ("Every day that we have been in this hospital he comes in the morning to see us and he brings about 2 med students with him and asks them a bunch of questions about everything"), and from your description,probably has thought about your son's problem along the same lines as most doctors would have tended to.....
UTI's in children(especially in newborns and infants) are at times difficult to diagnose - to put it mildly.The problem is in collecting the right sample of urine for a culture test or microscopy.One of the best urine samples for a urinary culture in children is urine that has been aspirated via a suprapubic puncture.Clinical manifestations of UTI in this age group is also unlike in adults.
The other concern in that age group is that if clinical suspicion of UTI is very strong, one may need to treat, pending culture reports. In other instances, antibiotics may need to be given even if labs are negative but clinical suspicion is too strong.
You say "Since the first incident, after being discharged when he was only 7 weeks old I had taken him back into emerg about 3-4 different times suspecting another UTI". Would you mind clarifying what symptoms made you to suspect UTI?
As the reports of the tests are awaited,it may be better to wait and then consult the specialist with all the reports on hand- otherwise it may cause further delay and aggravate your worries.
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