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Pediatrics/Puss cells in my 3 month old's stool, culture tests negative

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Stool microscopy
Stool microscopy  
QUESTION: Hello,

My son is 3 months old now, since he was one month old he has had bouts of runny frothy green mucusy poo. They come in waves and then they seem to go and then come back again. Every time we did a stool test it came out positive for excessive mucus and puss cells (latest one has 40-50 hpf and also this time RBC and occult blood). We also did 3 culture tests along with the normal stool test and every time the culture tests came out to be negative. After the first general test when he was 7 weeks old, we also gave him antibiotics ziffy as prescribed by our paediatrician but that didn't seem to cure anything as it doesn't seem to be a bacteria. I have stopped dairy for last week and now stopping all animal protein as well as wheat but I doubt this is food allergy as he is fine some days and then something starts and he gets worse. I also want to mention that he is a slow weight gainer. He was only 1 week early from the due date, his birth weight was 2.8 kg and now he is 3.85 at 3 months. My husband and I are both pretty thin and underweight according to BMI but very active. Baby, when he is well is also very very active, he doesn't look ill at all. He is smiling, trying to grab things and doing mini push ups as he should be at this age. So I am really puzzled as to what is going on in his stomach that creates these puss cells. Could it be a fungal infection? Could it be virus? He was inconsolable and wanting to suck all the time when he was younger and we gave him our fingers to suck on between 2 weeks to 5 weeks and I doubted whether he got anything from that, but there's no bacteria so what else it could be? Can we do any other tests apart from stool culture? I am attaching latest microscopy report. We did stool culture of the same sample and it came out negative. Thank you.

ANSWER: Is he THREE MONTHS old now? What animal protein are you talking about? Why are you giving him wheat? Is he not breast fed? If you do not have breast milk give a suitable formula and make sure you sterilize the bottles properly.

---------- FOLLOW-UP ----------

QUESTION: Yes he turned 3 months on 8th July. I have stopped eating animal protein which is eggs, fish and meat. I am not giving him wheat, I have stopped eating wheat. I have stopped dairy too thinking that he might be allergic to one of those things. He is mostly breastfed with an occasional (once in 4-5 days) single feed of lactose free isomil formula. We sterilise properly, although we give him formula rarely, but my question is why his puss cell count is going up and down when they cannot find any bacterial infection in the culture test?

Answer
Culture can be negative even though there are pus cells. If he is crying even after breast feed he may not be getting enough. There is no need to give lactose free formula unless he suffers from lactose intolerance. Check his weight regularly. Repeat stool examination after two weeks.  

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Dr. Arun Kumar Suri

Expertise

I can answer questions in the field of general pediatrics-questions regarding the development of children, immunization, feeding, weaning and common childhood problems like fever, cough and recurrent illness. Many of these topics are dealt with on my website Healthy Family Happy Family. Often a mother imagines that her child is sick when in fact there is no problem. Such a mother needs explanation and reassurance. I will not be able to answer specific questions regarding diagnosis.

Experience

I have more than 20 years of experience as a Pediatrician. I have been involved in the care of premature babies and also many critically ill children.

Organizations
I am attached to a Mission hospital in a small town in the Kannur dist. of Kerala in India. I also have my private clinic in a nearby place.

Publications
Most of my articles are on my website Healthy Family Happy Family. I have also contributed articles to Ezine Articles and Article City. I believe that Pediatrics is more than treating diseases in children. I advocate holistic approach to child health and problems of children giving equal importance to physical, psychological and spiritual health of children.

Education/Credentials
M.B.B.S. D.C.H. I have completed a distant course in adolescent health conducted by IMA AKN SINHA INSTITUTE. I have also completed an online course on Ayurvedic care of children conducted by Jiva Institute.

Awards and Honors
My website has been recognized by HONcode for trustworthy information on health. It has also been listed by familyfriendlysites.com/, healthdirectorymoz.com/Child-Health/ and medindia.net.

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