Suggest treatment for mucosal irregularity in bladder wall in a child
Patient: hello doc,my name is vivek and i ve a kid name athrv, age 1 yr 3 months, sex male.the patient is sick since over last two months having continuous gains/drops in fever. initially the doctor started the treatment of having infection in stomach. but that was of no use then suddenly the patient started losing his activeness and his temperature also started raising. one day his temperature got raised upto 104 deg celcius. the patient was rushed to some other specialist and he declared the disease to be pnemoniya, the doctor then started his treatment of having the symptoms of pnemoniya. after 2-3 days the doctor again said that he might have a doubt of the patient having some other issue also. he then conducted a ultrasound of the patient, the reprt of which stated that urinary bladder reveals mucosal irregularity seen involving the bladder wall. the doctor then said look i knew that there is some other problem then he stopped the treatment of pnemoniya and started paying attention to the infection in urinary instentine stating that this is the real problem and pnemoniya has got over.please advice Doctor: Hello Vivek, thank you for posting your question.The clinical diagnosis of any fever is based on a few principles. Firsly we enquire about the associated symptoms the child had with fever. Apart from that the extent and pattern of fever, whether it was associated with chills or came at any particular time of the day etc. These details would help us know what would probably have caused the fever and based on that investigations are usually ordered. In case of Athrv, as you informed he was initially treated for a stomach infection, then for pneumonia and finally for urinary tract infection. In such a situation you have two possibilities. Either he had 3 different kinds of infection which presented with fever over 2 months, in which case his fever should have subsided each time with the medication, he should have felt better and then again fallen sick with a new infection. If that is not the case then his fever could probably be attributed to a single cause , with the other two being misdiagnosis. In such cases investigations could give support and clue as to what the exact cause of fever is. Mucosal irregularities in urinary bladder is a very non specific finding and the diagnosis of a urinary tract infection should never solely be based on that. Associated symptoms of pain or difficulty in urination along with a positive urine culture is required for diagnosis. If you could provide any more information regarding what his urine culture report was, or what his associated symptoms were, then it would be much easier for me to provide you any further guidance.