Recurrent Urinary Tract Infection with Post-Treatment Urinalysis Concerns

Case at a Glance

A 33-year-old female presented with classic urinary tract infection symptoms following increased sexual activity. Despite successful antibiotic treatment and symptom resolution, patient expressed concern about persistent findings on follow-up urinalysis.

Patient's Story

The patient reported a constellation of lower urinary tract symptoms including dysuria, urinary urgency, and hematuria. She noted these symptoms developed after a period of frequent sexual intercourse with her spouse over one week. She was concerned about the potential relationship between sexual activity and her symptoms.

Initial Assessment

Initial urinalysis revealed significant findings consistent with urinary tract infection: leukocytes 70, RBC 8-10, WBC too numerous to count, and moderate epithelial cells. All other parameters were within normal limits. Based on clinical presentation and laboratory findings, the patient was diagnosed with acute cystitis and prescribed oral antibiotics.

The Diagnostic Journey

The patient experienced rapid symptom resolution even before completing the antibiotic course. Due to concern about treatment efficacy, she elected to obtain follow-up urinalysis approximately one month post-treatment, timing the test to avoid menstrual contamination.

Final Diagnosis

Acute bacterial cystitis, successfully treated. Follow-up urinalysis showed resolution of infection with normal leukocytes (negative), RBC 0-2, WBC 2-4, and persistent moderate epithelial cells.

Treatment Plan

Complete course of prescribed oral antibiotics as initiated. Patient education regarding the significance of epithelial cells in urine samples and the appropriateness of follow-up testing. Discussion of UTI risk factors including sexual activity and preventive measures.

Outcome and Follow-up

Excellent clinical response with complete symptom resolution. Follow-up urinalysis demonstrated successful treatment with normal inflammatory markers. Patient counseled that persistent epithelial cells likely represent sample contamination rather than ongoing pathology, and that routine post-treatment urinalysis is not indicated in uncomplicated UTI with symptom resolution. Patient advised to seek care only if symptoms recur.