Infection?

Dear Doctor,

I am a young woman of 27 years. Lately i've been feeling not well. Feeling weak, with low back pain and knee pains, fever of 37,4 grade celcius, lower abdominal pains and frequent and painful urination. I went at the gyn, the visit was ok, the ultrasound ok but she prescribed me polygynax for the vaginal discharges ( i've had recurrent bacterial vaginosis since i got sexually active). Now the medicine did not help and i continue to have very bad back pains that i hardly stand and knee pains. The urine analysis showed 6 leukocytes and a lot of crystals and epiteles. Does this mean that i have a UTI? I have never had any before getting sexually active ( always 0-1 leukocytes). Also the white blood cells are increased, there are 8 000. I guess these are sings of an infection. Does 8 000 mean leukemya? Mid number is very high 1.4 and Mid percentage  is 17,6%. Both very high. What is their meaning? What is going wrong? When it comes to red blood cells there are 4.1 M/uL, but MCV is high as well, 97,7%. Please can you give me any advice of what could be wrong with me, or what other tests should i do if any and what doctor to contact ( a urologist)? my ERS was 14mm/hour. Is this a high value? Could it be related in some form with my knee and feet pains?

Thank you very much for your help and advice.

[Elaine Brown, MD]

Hi!
It can be very difficult to interpret lab values, because different laboratories use different normal ranges.  A couple of things:  I strongly doubt leukemia, and it does NOT sound like you have a UTI--even if you did, the medication should clear it up.
A urine culture would be the test of choice, and if done should include antibiotic sensitivities too.
I think that your general doctor is still probably the best person to see until something specific is discovered, however, if you want to see a specialist, I would suggest a Rheumatologist--this type of doctor specializes in joint pain, and diseases that cause joint pain and inflammation.  You could see a urologist re the painful urination, but he/she is not going to know much about knees, feet or back,
Good luck!

Dr B