9 months male baby (DOB:27 April 2010) had following problems in the same sequence
1. Very first time a drop of pus was observed flowing through his penis(24th November 2010).
2. Routine report showed 20-22 /hpf pus cells and protein trace.
3. Culture report showed 1,10,000 colony count with organism E Coli
4. Was treated with norflox (oral antibiotic) for 10 days 1/2 tablet twice a day 100 mg and tests were repeated
5. Routine report showed occasional pus cells.
6. Culture report showed 80,000 colony count with organism E Coli
7. MCUG report shows trabeculated bladder with dilated posterior urethra and a bladder diverticulum with Grade II reflux on right kidney.
8. Ultrasound report said
Bladder shows slightly thickened and irregular walls
May be seen in infection ADV: follow up
A small suspicious diverticulum in the right posterior wall.
9. A urine catheter was then put on to him with IV antibiotics(Meropenem) for 2 weeks.
10. Pediatric Surgeon said MCU is suspicious of PU valves.
11. As per suggestion of a Pediatric Surgeon he underwent through a PU (Posterior Urethral valves) fulguration through cystoscopy on 11th Jan.
12. He is kept on Magnex IV antibiotic for 6 post operative days along with the urinary catheter.
13. After a week catheter was removed. He was given Taxim-o oral antibiotic twice a day.
14. After one week of oral antibiotic unfortunately he again shows multiple pus cells in his urine report and again the same organism E-coli can be seen.
16. He is now again on 14 day IV antibiotic.
15. Pediatric surgeon now suggests that we need to do ureteral reimplant surgery.
16. Took a second opinion from another pediatric surgeon and he said that ureteral reimplant is not necessary and we should see that the infection is eradicated completely.
17 As of now he has fever about 100-101 and is been controlled by paracetamol/ibuprofen. If fever doesn't go down he is suggested to have an urine catheter again to release the urine bladder pressure.
Not sure as how to proceed