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Urology (Expert Forum)
6-week-old girl has white blood cells in urine and 0.3 blood creatinine
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
6-week-old girl has white blood cells in urine and 0.3 blood creatinine
by Denis-Wise, Oct 22, 1998 12:00AM
My 6-week-old daughter has been hospitalized for 2 days, due to a persistent (10 days) low-grade fever. Her appetite has decreased and she didn't gain as much weight as expected between well-baby visits. White blood cells showed up in urinalysis, and the only CBC test that fell outside of the normal range was the 0.3 blood creatinine (BUN was within normal range).
Blood, spinal and urine cultures are due back today.
Does this combination of systems indicate anything of which you're aware?
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Dear Dennis,
Your daughter may be having urinary tract infections. She should be investigated for vesicoureteric reflux (VUR). Normally the urine from the bladder is not allowed to go back in to the kidney. In some kids, this valvular mechanism is not fully developed. This results in a retrograde flow of urine and bladder bacteria to the kidney. VUR predisposes these individuals to urinary tract infections, which, if untreated can result in kidney damage.
Reflux is most commonly diagnosed by the voiding cystourethrogram (VCUG). Most commonly employed treatment for VUR is long-term antibiotic therapy (prophyllaxis), which can prevent infections while the valve mechanism develops adequately.
If medical therapy fails, this condition can usually be treated by surgery. At this time however, your daughter needs a pediatric urology consult and proper baseline investigation. After that a scientific management plan can be formulated.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. Dr. Stephen Liroff at the Henry Ford Hospital, Department of Urology has experience in the evaluation and treatments of problems such as you describe. He would be most interested in helping you. You can reach him through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need. Please bring any x-rays (not just the reports) as well as any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly.
Sincerely,
HFHS M.D.-A.T.
*keyword: VUR, ureterovesicle reflux
