Q: My 70 years old father has been suffering from vomiting and high fever (102 degree Fahrenheit) with a burning sensation while urinating for over a month and a half. He has been diagnosed with urinary tract infection (UTI). He was given intravenous antibiotic for five days but after a couple of days, the problem recurred and he was readmitted to the hospital and intravenous antibiotic repeated. His blood urea was 65 mg/dl, creatinine 3.3 mg/dl and TLC 12700/mcl while the other reports were normal. Following the antibiotic course, his creatinine was 3.3 mg/dl, TLC normal and blood urea 50 mg/dl. He was prescribed - amlopress, dytor, minipress, orefor and becosules for five days. On the seventh day, his creatinine remained 2.7 mg/dl and the doctor changed the medicines. Following this, the problem recurred and he was admitted to the hospital, where his TLC was found to be 13000/mcl, high pus cells in urine – 25 with raised urea and creatinine . The doctor said that the problem recurred due to gap of two days in the medication. Why is UTI recurring and how can it be permanently cured?

A:Your father is suffering from complicated urinary tract infection (UTI). While simple UTI may be treated with antibiotics for 3 to 4 days, and result in a cure, complicated UTI have an associated anatomical cause, resulting in its repeated recurrence, or persistence. Mot common cause of such UTI in elderly males is prostatic obstruction. Other common causes are a stone, obstruction due to any other cause, or an abscess in any part of urinary tract. Complicated UTI is most common cause of sepsis and ICU admissions in elderly males. Your father needs proper imaging and functional investigations to find out THE anatomical cause, which has to be treated to prevent recurrence of UTI.