Is it possible to contract a urinary problem from a lake?

[Tawna]

Hi, after vacationing for a week at a New England Lake, my daughter and I started experiencing lightheadedness, and fatigue, and my daughter complained of an urgent need to urinate.  I passed it off as a virus until my father-in-law, who was also on vacation with us was suddenly admitted to the hospital with severe dizziness.  He was diagnosed with a blood and bladder infection and put on antibiotics which seemed to do the trick.  Since my daughter and I still seemed to be feeling the symptoms I thought I'd better get us checked out, so we left a urine sample.  Both samples showed blood present and for my daughter protein.  My daughter was given Amoxicillan but after the 10 day period no improvement was noted.  I took her back, she then had a blood test (I believe a "liver scan") and an ultrasound of her kidneys.  These proved unhelpful so they are now recommending she see a pediatric urologist.  Since this process seemed to be slow going,  (Her appointment is still over a month away) I asked them to do another urine sample.  Mine is now clear, hers is still showing blood and urine.  Through all this, no one seems to be taking the lake issue seriously.  We were staying in a very shallow part of the lake and the last few days we were there, there was a boat and divers pulling up the milfoil from the bottom of the lake where we were staying.  There were also a large number of geese around quite often which left quite a bit of droppings in the area.  Other than the slight fatigue, and occasional light headedness I seem to be fine, but the urinary urgency is really tough on my daughter.  She attempts to get through school, but literally will go to the bathroom probably 25 times during her day.  

These are my questions:  Since this has been going on for about 7 weeks now, is it reasonable to consider that it is a virus?

Could the stress of trying to get through a school day be contributing to the protein and blood in the urine?

Is it something I should "wait and see" on rather than subject her to further invasive testing?

Does this type of thing ever come from swimming in a lake?

Thanks so much for your time..

[Kevin Pho, MD]

To answer your questions:
1) A viral cause is possible.  Sending the blood and urine out for culture should be considered.  However, urinary urgency should be evaluated for non-infectious causes - for instance, genitourinary causes, diabetes or thyroid disorders.

2) I would rule out other, more serious diseases (see above) before considering stress as a cause.

3) Further testing can be done with urodynamic testing as well as possible imaging studies.  A referral to a pediatric urologist can be considered.

4) Infection can certainly enter the body from the lake.  Thorough cultures can be considered to investigate this possibility.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_