recurrent UTI

[agatha1]

I have been suffering with symptoms of recurrent UTI (urinary frequency and urgency, cloudy odd smelling urine, pain above the pubic bone, microscopic haematuria, nausea, rigors low grade fevers chills, night sweats,occasional flank pain).  The symptoms started 3 years ago shortly after I had a very strange respiratory illness (I thought I had pneumonia because it really hurt to breathe but I had only a very mild fever).  This led to sinusitis and congestion of the eustachian tubes,  a very peculiar headache and brain fog and a few weeks later the UTIs started.  The urinary symptoms now always flare up with the sinusitis, headache and brain fog - usually when I get tired.  However my urine tests always come back negative (nitrites, leucocyte esterase and standard urine culture).  Trimethoprim always makes the symptoms go away but they flare up again about a week after the antibiotics finish. Amoxicillin is ineffective.  I often get some pain in the underarm lymph nodes as I recover. My doctor has suggested Interstitial Cystitis but this doesn't fit  some of the symptoms (eg nausea, rigors, night sweats)  and doesn't explain why Trimethoprim helps but Amoxicillin doesn't .My gut feeling is that I have some sort of odd persistent infection which has migrated from the respiratory tract to the bladder (I feel my body fighting in the way it does when I get the flu and it explains  the positive effects of Trimethoprim) - but I don't understand why the tests keep coming back negative.  Any ideas?

[Stephen Liroff, MD]

My answer to is quite brief: "no, I do not have any ideas and the history does not hang together." I suggest that you go to a university medical center internal medicine clinic and make sure that you are seen by a senior staff physician.
S.A.liroff, M.D.