Am on methatraxate & recently had problems with passing water .Has gone on for a few weeks and on 2nd visit to dr last Wed was given urine test . Results back today - had text message from dr to collect antibiotics as e-coli infection ( which I might have had for several weeks)
Test results as follows
408 /ul urine microscopy pus cells
5.0 u/l urine microscopy red cells
12.0 /ul Epiithelial cell count
2.0 /ul Urine microscopy-casts
I do not know what these results mean ( good or bad) Coukd anyone please advise me as dr has not requested me to contact him except to pick up antibiotics.
Not sure whether I am having psoriatic arthritis flare or the infection but I have been really fatigued over past week and am due next methatraxate jab which of course I will now postpone as will be on antibiotics.
Any advice appreciated.
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Red1973
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I can't help with analysing the results but how often do you have blood tests for MTX? If you've had a UTI for weeks, I would have thought your white cells would be raised, hasn't anyone spotted this?
Having spoken to rheumatology today they dont seem too worried - just want me to finish antibiotics ( only started them yesterday) then have blood test before taking next methatraxate
Your results just confirm presence of a bacterial infection. There’s not much more the gp can do, but prescribe antibiotics. If you don’t feel better after the course I’m sure they’ll review you. If your joints haven’t flared, the fatigue is likely a symptom of the UTI, so should improve once the antibiotics kick in. E-Coli is often found in the urine. Hope you feel better soon
I would agree about fatigue being a likely side effect of the UTI although I take hydroxychloroquine not methotrexate - when I have had a UTI and I’ve had quite a few over the past couple of years, I feel utterly wiped out. Obviously there could be other reasons - how are your vitamins and minerals etc?
Can you ask your GP to do blood tests and include vitamin D3, B12, folates and ferritin as well as a full thyroid panel you need your vitamin and minerals well up in their lab ranges for you to feel good and if your thyroid isn’t optimal for you you can feel pretty tired too. Also I seemed to be taking so many antibiotics for the repeated UTIs that I now take a probiotic along with antibiotics
Spoke to Rheumatology helpline - they have told me to complete antibiotics course and have new blood test before restarting methatraxate.They don’t seem too bothered re the fatigue and I don’t know whether that’s from the e-Coli or metatraxate ( although not taken latter for 2 weeks)
Had blood test for Urea and Electrolytes last week which have come back ok.
Had thyroid test August TSH 1.79 deemed ok.and had full blood test then.
Had better not ask for any more blood tests just yet as I am sure they think I am exaggerating when I tell them so many symptoms. (Also Diagnosed with Psoriatic Arthritis and Cervical Myelopathy )
All very well them not being bothered about your fatigue - it’s not them who is fatigued. Anyway, I have always been prescribed nitrofurantoin. They always send a sample off for testing to make sure I’m given the right antibiotic and it is surprising how long it takes for a result. I know as soon as it has been done because the results pop up on my MyChart and I always see any blood / UTI test results before my GP comments on them (if they are going to comment)
I’m surprised they keep prescribing the same antibiotic. My UTIs seem to be caused by e-coli too. It really is exhausting. You have to wonder if people realise just how exhausted you are when you tell them that otherwise they might be a bit more sympathetic. The best thing you can probably do is try to rest as much as possible and drink as much water as you can manage.
Oops sorry probiotic! The last ones I took were Probio7 - normally I take Optibac both of which are designed to take with antibiotics.
Yes note that you are on hydroxcychorine and not methatraxate.Had seen somewhere that you shouldn’t take Nitrofurontin if you are on methatraxate as it could cause complications- raised it with rheumatology quoting what was said and they told me it’s fine to take them together.
It’s quite weird isn’t it. I’ve heard that you shouldn’t take ibuprofen or paracetamol if you have asthma but my doctor said if I can take it without a reaction - although I have no idea what a reaction would be - then to carry on taking it. What can you say to that? Perhaps it’s the same with methotrexate and nitrofutorin.
I was told by my senior biologics nursing sister, don’t take Nitrofurantoin when on Mtx, but I’m not sure as this was because I had chronic bronchitis that hadn’t been brought under control at that time.
Looking at your profile I presume that you are male. UTIs in men can be caused by an enlarged prostate, this makes completely emptying the bladder more difficult. The stale urine encourages the build up of infection.
A couple of years ago I had a UTI which had me going to the loo every hour day and night. The doctor arranged a PSA test (normal) and did physical check on my prostate and confirmed it was a bit enlarged. He prescribed Tamsulosin to relax the bladder and this has helped my bladder function.
From my experience maybe you should be having a prostate and PSA check.
I got 7 days of antibiotics and it wasn't till the last dose that I felt symptom free. My GP was happy to give me another 3 days of antibiotics when I asked for them to ensure the infection was gone.
I would be making sure you had sample bottles in case you feel symptoms returning and can get them tested quickly.
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