54-Year-Old Woman Experiences Hematuria Due to Urinary Tract Infection – The Importance of Hydration and Early Treatment

Medical Case Overview (For Educational Purposes Only – Patient Privacy Protected)

This case study explores the diagnosis and successful treatment of a 54-year-old female patient who presented with symptoms of a urinary tract infection (UTI), including visible blood in her urine. After timely medical intervention and proper antibiotic therapy, she made a full recovery within one week. This article highlights the signs of UTIs, effective treatment protocols, preventive strategies, and why early action—along with consistent hydration—is crucial for urinary health.

Patient Profile & Clinical Background

Gender: FemaleAge: 54 years oldPresenting Symptoms: Frequent urination, urgency, painful urination, lower abdominal discomfort, and gross hematuria (visible blood in urine)Hospital: First Affiliated Hospital of Xi'an Jiaotong UniversityDate of Consultation: August 2019Treatment Plan: Oral antibiotics and urinary alkalizing agentsTreatment Duration: 7-day course with follow-up evaluationOutcome: Complete resolution of symptoms and normalization of lab results

Initial Diagnosis: Recognizing the Signs of a UTI

The patient, referred to as Ms. Lu, visited our clinic complaining of sudden-onset urinary symptoms that began approximately 24 hours prior. She reported experiencing frequent urges to urinate, accompanied by sharp pain during urination and a persistent feeling of incomplete bladder emptying. Notably, she observed pinkish-red discoloration in her urine—indicative of hematuria—which prompted immediate concern.

She also mentioned mild difficulty passing urine and a dull ache in her lower abdomen. Her medical history included stage 3 hypertension and arrhythmia, but no prior history of recurrent UTIs. Upon physical examination, we noted tenderness over the suprapubic region—where the bladder is located—but no rebound tenderness or palpable masses. Abdominal auscultation revealed normal bowel sounds, and there were no signs of external urethral inflammation or discharge.

Diagnostic Testing Confirms Infection

To confirm our clinical suspicion, we ordered a urinalysis. The results showed significantly elevated levels of red blood cells (RBCs) and white blood cells (WBCs), along with high bacterial counts and presence of mucus threads—classic markers of an active urinary tract infection. Based on these findings and her symptom profile, we diagnosed acute cystitis caused by a bacterial UTI.

Effective Treatment Strategy Without Hospitalization

Given that the patient did not exhibit systemic symptoms such as fever, chills, nausea, or vomiting, we determined that outpatient management was appropriate. We explained to her that most uncomplicated UTIs can be effectively treated at home with targeted oral medications.

Prescribed Medications and Their Roles

We prescribed a combination regimen tailored to address both infection and symptom relief:

• Compound Cefaclor Tablets: A broad-spectrum cephalosporin antibiotic used to eliminate gram-positive and some gram-negative bacteria commonly responsible for UTIs.
• Levofloxacin Hydrochloride Tablets: A fluoroquinolone antibiotic effective against a wide range of uropathogens, providing additional coverage and rapid bactericidal action.
• Sodium Bicarbonate Tablets: Used to alkalinize the urine, which helps reduce bladder irritation, alleviate burning sensations during urination, and prevent clot formation from blood in the urine.

We emphasized strict adherence to the 7-day dosing schedule and advised her to apply warm compresses to the lower abdomen to ease discomfort. She was instructed to return after one week for reassessment and encouraged to seek urgent care if new symptoms developed.

Positive Treatment Outcome After One Week

At her follow-up appointment, Ms. Lu reported complete relief from all urinary symptoms. She no longer experienced frequency, urgency, dysuria, or hematuria. Physical examination confirmed the absence of suprapubic tenderness, indicating resolution of bladder inflammation.

Lab Results Show Full Recovery

A repeat urinalysis demonstrated normalized values: RBCs, WBCs, bacteria count, and mucus threads had all returned to within standard reference ranges. These results confirmed clinical and laboratory remission of the infection. No further treatment was required, and she was discharged with preventive advice.

Key Preventive Measures to Avoid Recurrence

While we were pleased with the successful outcome, preventing future infections remains critical—especially for middle-aged women who are more susceptible due to anatomical and hormonal factors. Here are essential recommendations we shared with the patient:

1. Stay Well-Hydrated and Urinate Frequently

Drink plenty of water throughout the day—even when not thirsty. Aim for at least 6–8 glasses daily to maintain dilute urine and promote regular flushing of the urinary tract. This simple habit reduces bacterial colonization and lowers the risk of infection.

2. Maintain Proper Genital Hygiene

Practice gentle but thorough cleaning of the perineal area, wiping front to back after using the toilet to avoid introducing gut bacteria into the urethra. Avoid using harsh soaps or douches, which can disrupt natural pH balance. Additionally, opt for showers instead of baths when possible to minimize exposure to stagnant water that may harbor bacteria.

3. Practice Safe Intimate Habits

For sexually active individuals, urinating shortly after intercourse helps flush out any bacteria that may have entered the urethra. Using adequate lubrication and maintaining good hygiene before and after intimacy can also play a significant role in reducing UTI recurrence.

Clinical Insights: When to Treat at Home vs. Hospitalize

This case underscores an important principle in managing UTIs: severity dictates treatment setting. Uncomplicated lower UTIs like cystitis often respond well to short-course oral antibiotics without requiring hospital admission. However, patients presenting with fever, flank pain, vomiting, or signs of sepsis may have progressed to pyelonephritis (kidney infection) and require intravenous antibiotics and close monitoring in a hospital environment.

Why Early Intervention Matters

Delaying treatment can lead to complications such as kidney involvement, chronic infections, or even permanent renal damage. Moreover, visible hematuria—while alarming—can result from benign causes like UTIs, but it should never be ignored. Prompt evaluation ensures accurate diagnosis and peace of mind.

Final Thoughts: Empowering Patients Through Awareness

Urinary tract infections are common yet highly treatable conditions. As healthcare providers, our goal is not only to cure the current episode but also to educate patients about prevention and self-care. Encouraging hydration, promoting hygiene awareness, and recognizing early warning signs empower individuals to take control of their urinary health.

In conclusion, this case illustrates how timely diagnosis, evidence-based treatment, and patient education lead to excellent outcomes. By staying informed and proactive, patients can significantly reduce their risk of recurrent infections and enjoy better overall wellness.