Urology/Accute pyelonephritis in a 9 month old
I am very concerned about son.
Here is our story. We are Americans but live in Russia right now. (I am originally from here). my son has been a very needy baby and has slept really bad since birth (wakes up every 20-40 minutes at night and day). About 3 weeks ago he had a very high fever for about 3-4 days (102-103 degrees), no other signs like cough or discharge from the nose. Since he was teething and his gums were super red his pediatrician blamed it on it plus he had a red colored throat. I gave him fever reducers (ibuprofen) every 6-8 hours for about 3 days. On the forth day he wasn't any better so his doc proscribed anibiotics. The next day we had his urine and blood tests done. The urinalisus showed a big amount of leukocytes and blood test showed leukopenia and low hemoglobin. Also on the forth day he developed red blochiness on his face then little pimples on his body. But his fever was gone! His ped started to think it was a viral kids disease but from all the fever reducers, high fever and dyhidration kidneys didn't function the way they should have been and that's why the test had such results. Also his urine had kots of white particles and strings that floated in there. The next day we had a urinalisus done again and it again showed high amount of leukocytes. Even though his doc said not to worry we decided to get admitted to the hospital where nephrologist said its pyelonephritis. He was treated with 3d generation antibiotic shots for 5 days twice a day (cefotaxime) then Cefixime orally for 14 days. Ultrasound was normal, blood test for creatinine and uric asid was normal but still showed leukopenia. He was all the way better and urine test was normal even though it still had white particles in it. The funny thing is that he slep really good in the hospital! (woke up only 2-3 times at night). I might suspect he was catching up on all the sleep he missed before that but maybe there was some reason to it. We were discharged from the hospital but had to continue with medication: Cefixime for total 14 days then Furagin 12.5 grams 3 times a day for 10 days then 15 grams once a day for up to a month. Also dimephosphonum for a month.
Anyway we checked his urine a week ago, it was normal. His blood test was back to normal too. I collected urine today for another test and don't know the results yet but there are lots of particles in it again!! By the way a couple of days after we came home from the hospital he started to sleep really bad. Maybe it's just a habit of his but what if we are missing something? Also when I asked doctors what caused this sickness they said that possible its a metabolic disorder because my husband is suffering from gout.
We trust the doctors here as much as we can and I know sometimes treatment approaches differ in different countries. I really want to get an opinion from an American side. What do you think about all of this? Do you think it was pyelonephritis? Does it sound like he treatment was right? Also what are these white particles that look like pieces of chalk and some of them are stringy looking???
I am sorry for such a long explanation but I feel like I need to mention everything. I also want to mention that since birth he has been having high eos count (about 6-12).
I would really appreciate your input!
My limited experience with Russian physicians is that they are well trained and capable but lack access to some of the latest technology that we take for granted here. Given that, his treatment seems reasonable. It is extremely doubtful that a metabolic disorder like gout caused the infection, but that doesn't rule it out either.
I suspect your son had pyelonephritis or at the very least a severe UTI but I can't really tell from here. Right now, he needs to get better. This will require an investigation into why he developed the infection. This usually means an IVP (intravenous pyelogram)or CT urogram PLUS a VCUG (Voiding CystoUrethrogram) which is an x-ray done to see if the bladder urine backs up into the kidney during voiding. If so, he may need some ongoing prophylactic therapy.
I can't comment on the particles since they have not been identified.
See if you can find a pediatric urologist. A larger university center would be more likely to have such a specialist.