OpenHealth Q&A

Concerns Over a Possible UTI Following Kidney Stone Episode

Hello there, I'm a 32-year-old woman who may have recently passed a kidney stone, although my test results were somewhat ambiguous. I am currently taking Lexapro, Lamictal, and metformin (for PCOS), along with a multivitamin. I apologize for the lengthy message, but I believe all these details are quite pertinent to my situation. To summarize; I'm feeling quite bewildered by the entire situation. About a week and a half ago on a Saturday, I began experiencing pressure and a mild ache in the left side of my pelvis, which extended into my back. While the discomfort wasn't severe, it prompted me to contact my OB-GYN, suspecting it could be a cyst due to my PCOS, although I had never experienced one before. They advised me to wait longer since the pain was manageable and they were fully booked until April. Throughout the following week, the discomfort became more pronounced, though still not extreme. On Thursday night, I started feeling notably nauseous and fatigued, but managed to sleep. However, the next day, I found it almost impossible to get out of bed due to overwhelming fatigue and abdominal pain, which limited me to a single comfortable position. I was struck by severe nausea, occasional vomiting, and alternating hot sweats and chills, but I didn’t develop a fever. Consequently, I scheduled an urgent visit with my primary care provider (PCP). During my Friday appointment, after a thorough examination, it was concluded that a cyst was unlikely, prompting testing for a urinary tract infection (UTI) and vaginitis. They conducted a comprehensive blood panel, a urinalysis, and a vaginitis test. The vaginitis results came back negative, and the metabolic panel was normal. However, my complete blood count (CBC) showed some abnormalities: 88.5% neutrophils, 5.6% lymphocytes, and 0.1% eosinophils. The urinalysis indicated problems as well, revealing trace leukocytes, trace ketones, blood in the urine, and 11-20 red blood cells per high power field, but no bacteria were detected. They later informed me they believed I had a kidney stone and arranged for a renal ultrasound the following week. On Sunday morning, my urine culture showed 1,000 grams of positive bacteria. By Saturday, the pressure and discomfort had subsided, yet I was still feeling extremely nauseous and now also experiencing migraines. I couldn’t tolerate the nausea and ended up at the urgent care again on Sunday, recalling how I had felt during my first pregnancy with hyperemesis. Water was my only solace during this ordeal. At the Sunday appointment, they had me undergo all the tests once more, including another CBC, metabolic panel, urinalysis, urine culture, and even an abdominal x-ray. The metabolic panel returned to normal, and the CBC results remained within acceptable limits, except for a slight rise in lymphocytes and monocytes. The urinalysis revealed trace leukocytes and blood but no alarming results otherwise. However, the abdominal x-ray did not show any kidney stones, though it was somewhat compromised due to gas and bowel content. The radiologist concluded that I had constipation, and they provided me with Zofran to address my nausea. The urine culture from this visit indicated a significant increase to 10,000 grams of positive bacteria, ten times more than the previous reading. While the Zofran helped alleviate my nausea, it caused a severe migraine. Reflecting on everything that transpired over the weekend, I felt it was necessary to consult my PCP for additional clarity on my condition. During my Monday appointment, I sought a comprehensive understanding of the events and what steps to take going forward. At this point, I was eager to avoid experiencing anything similar to the previous weekend. No new tests were conducted during this visit. We discussed the various scenarios, and my PCP suggested that my illness on Friday might have coincided with the passing of the kidney stone, explaining the dramatic shift by Sunday. She also noted that my constipation could be attributed to the fact that I hadn’t eaten for four days, which compounded my pain. We established a plan to proceed with the renal ultrasound, although it wasn't urgent, and I was told to reach out if anything significant arose from the tests. Regarding the follow-up urine culture results, my PCP reassured me that the previous low count wasn't concerning, but an increase might require further attention. When the second urine culture results came in, the urgent care physician reported that there was no infection detected. I'm still grappling with confusion and uncertainty about the visits and diagnoses from the weekend. Is it reasonable to associate the kidney stone with the symptoms I experienced, and should I be worried about the jump from 1,000 to 10,000 grams of positive bacteria? I'm now questioning whether to reach out to my healthcare providers again or to let it go for the time being. Presently, I feel mostly improved; there’s some slight pressure on my left side, but it’s not painful, and I’ve been drinking plenty of water amidst some mild discomfort when urinating. Thank you for taking the time to read through my experience. Your insights would be greatly appreciated!

Answers (1)

3/26/2025, 12:11:36 AM

OpenHealth AI

Thank you for sharing your detailed experience. It sounds like you've been through a lot recently, with the uncertainty surrounding your kidney stone episode and the changes in your health. Let’s break down your concerns regarding the possible connection between your symptoms, the kidney stone, and the urine culture results.

Main Points

• The symptoms you experienced, including pressure in the pelvis, nausea, and fatigue, could be related to both the passing of a kidney stone and the urinary tract changes.
• While the significant rise in urine culture bacteria is concerning, your healthcare providers did not detect an active infection based on the results after additional analysis.

Explanation

1. Kidney Stones: It is reasonable to associate your symptoms with kidney stones. The pressure and discomfort you felt could be a direct result of the stone moving through your urinary tract, which can cause symptoms such as abdominal pain, nausea, and even vomiting.

2. Urinary Culture Results: The jump in bacterial count from 1,000 to 10,000 may raise a flag, but your healthcare providers determined that there was no active infection based on follow-up cultures. This suggests that while there was an interaction with bacteria, it might not have been significant enough to warrant immediate concern.

3. Current Symptoms: Since you feel mostly improved and your symptoms have stabilized, it's a positive sign, especially as you're staying hydrated and managing mild discomfort.

Next Steps

1. Monitor Symptoms: Continue keeping an eye on how you feel. If you notice any resurgence in pain, significant changes in urination (like frequency, pain, or blood), or new symptoms develop, consider reaching out to your provider.

2. Hydration and Diet: Ensure you’re drinking plenty of fluids to help flush out any remaining stone fragments and keep your urinary tract healthy. Incorporating a light diet may also help with any residual discomfort.

3. Follow-Up on Tests: Stick to your plan for the upcoming renal ultrasound, as this will provide more clarity about your kidney health and any residual stones.

4. Communicate Concerns: If at any point your discomfort increases or doesn’t improve, or if new symptoms arise (like fever or worsening pain), don’t hesitate to contact your healthcare provider sooner rather than later.

5. Consider Additional Support: Since you've had considerable nausea and fatigue, discussing additional options for symptom management with your doctor may also be beneficial.

Reassurance

It’s completely normal to feel bewildered after the medical evaluations you’ve undergone. You are taking the right steps by seeking clarity and looking to understand your condition better. Continue to prioritize your health and comfort, and reach out if you feel uncertain at any point. Your well-being is what matters most.