a 62 years old woman with a history of renal transplant since april 2007 , complained of recurrent severe uti since may 2011 with symptoms of fever ,chills, burning in urination , oligouria &severe pain.urine culture: e.coli . hb was 10 other day 9,endoscopy &colonscopy were made and polyps founded in colon, removed.tinam iv for 5 days & blood transfusion.Three dats later same symptoms but uine and blood culture: enterobaccter , treated with tinam iv 4 times daily for 2 weeks then ciprofloxacin500 bid for 3 weeks. After four days same symptoms, urine and blood culture: salmonella trated with rocephin iv bid for 48 hrs then cefixime 400 mg bid for 2 weeks. After one week same smptoms with less severity no fever only oligouria & burning in urination , urine culture: e.coli.treated with more cefixime 400 mg bid for one week more.ever thing were good for about 2-3 weeks then same symptoms wiyh vomiting and diarrhea, urine culture: e.coli treated with cefixime 400 mg once daily for 10 days. After one week same symptoms , urine culture: e.coli treated with cefaclor 500mr bid for seven days then repeat test after 5 days from stopping antibiotic, urine culture no bacterial growth.Repeating tests after 2 weeks urine culture : no bacterial growth but the patient is too much fatigue and all the way she is dehydrated although she took too many fluids orally and iv, the complain now is from increased urinationat night( she is diabetic as aresult of using prograf postop. renal transplantation) she made tests last week every thing were good even creatinine: 1.1 ans glucosylated hb (ac1): 6.5. Today unfortunately creatine :1.85 , hemoglobin: 9 , the patient is very tired and fatigue and complain of muscle pain . Her medications: prograf 1 bid , prednisolone 5mg once daily; lansaprazole 30 mg 1*1; dilzem bid; dilatrend 25 mg bid ; lipitor 20 mg 1*1; lopid 600 mg 1*1; januvia 1*1; amaryl 6 mg 1*1; novonorm 1mg 1*1; glucophage 500 1*3 or as needed.