Bladder Infection or something else?

Doctor-

I am 19 years old, female, healthy other than a recent bout of subacute thyroiditis and then this problem. Three weeks ago I woke up on morning and went to the restroom like I always do but for some reason still felt like I had to go really badly. This lasted all day and and partly into the next, got a little better for a few days, and then got persistently worse. No burning or anything, just a constant extremely annoying urge. By the time I made it into my doctor's office, this had been going on for a week.

My doctor did an uranalysis and said that there were white blood cells and some bacteria in my urine so she put me on levaquin for 5 days. It seemed to get a lot better the first three days, but then stopped working and it just started to get worse again. Unfortunately, my doctor was out of town for a week, so I went to a walk in clinic the day after I finished my round of antibiotics. The took a sample and culture, both of which came back negative & said they found nothing to indicate an infection.

The walk in clinic sent me to a urologist. He took a sample, said there were white blood cells in my urine, put me on 10 days Bactrim but sent out a culture just to see. This morning his nurse called to say culture was negative. I asked her to ask the doctor if I should continue my antibiotics but no response.

When I was really little I had a few urinary tract infections, but since then I have only had maybe one every two or three years. This time, I have no burning or incontinence or pain of any sort. I'm not neccesarrily going any more than usual and I never wake up during the night to go. It's just the constant FEELING of having to go.

Do you think that I should continue my antibiotics? Could I still have an infection even though its not showing up? If not, what else could it be? I have read about things like interstitial cystitis and even though it doesn't sound like that to me I'm still worried. Any help would be greatly appreciated.

[Stephen Liroff, MD]

The constant urge to urinate sounds quite bothersome, but with negative urine cultures, there is no sense in continuing your antibiotics. If you have persistently elevated numbers of white blood cells in your urine (assuming that these are midstream, clean catch samples) and your bladder has been shown to empty each time that you urinate, then your urine should be specifically cultured for tuberculosis. Tuberculosis of the urinary tract is not common these days but it does occur.
If you are not emptying your bladder, then your urologist  will need to work you up for the cause of this in such a young individual such as yourself. A damaged spinal nerve? high grade reflux into one or both ureters (may relate to your urine infections as a child).
Also, a pelvic ultrasound may reveal something pushing on your bladder, such as an ovarian cyst, or an enlarged uterus (pregnancy),
Kidney stones rarely can cause urinary frequency but usually there would be increased numbers of red cells in your urine and pain on one side of your back/abdomen.
Return to your urologist and raise these specific concerns.
S.A.Liroff, M.D.

[pab234]

also I was on levaquin for 5 weeks followed by doxycycline for 2 right before I started having these issues to get rid of a stubborn mycoplasma pnuemonia (pneumonia) infection in my lungs. could I have an infection due to some wierd resistent bacteria and that's why the antibiotics i'm taking now aren't working?