click below
click below
Normal Size Small Size show me how
Peds UTI
Pediatrics
Question | Answer |
---|---|
Sporadic UTI = | ≤ 1 UTI/6 mos and ≤ 2 UTIs/year |
Recurrent UTI | ≥ 2 UTIs/6 mos or ≥ 3 UTIs /year; Relapse / Reinfection |
UTI epidemiology | M>F until 6 mos; after 6 mos, F>M; by 2 yo, M:F 1:10 |
UTI prevalence in older | 2-18 yo: 0.1-0.5% M, 1-5% F; adult F 1-3% |
UTI s/s in newborns | Fever, Sepsis, Jaundice, Vomiting, Failure to thrive |
UTI s/s in infants/preschool | Fever, Vomiting, FTT, Diarrhea, Abd/ flank pain, New onset incontinence; Dysuria; Urgency |
UTI s/s in school age | Fever; Vomiting; Abd/ flank pain; New onset incontinence; Dysuria; Urgency; Frequency |
UTI dx | UA & UCC; Blood tests; Radiologic studies |
UA for UTI: LE & nitrite | LE: about 80% sens/spec; nitrite 50% sens, 98% spec |
RBC casts | glomerulonephritis |
Positive UCC = | >100K if clean catch; >10K if cath; any growth if suprapubic |
UTI blood labs | CBC/diff; chem; blood cx; CRP |
Distinguish upper vs lower UTI by: | clinical judgement |
UTI orgs | E coli no. 1; Klebsiella 2nd most common; proteus M>F |
UTI orgs uncommon in kids | Enterococci (uncommon >1 month); coag neg staph, SA; GBS |
Cystitis tx | TMP/SMX; Cephalosporins (cephalexin, cefixime); Amox (?with clavulanate); 7 – 10 days |
Fn of US & VCUG | US: anatomy; VCUG: check for vesicoureteral reflux (Normal to Grade V) |
Reflux | 30% familial; Abx, surg (Reimplantation; Endoscopic placement of bulking agent) |
Pts 2 mos-2 yo who don’t have expected clinical response within 2 days: | US ASAP; VCUG or RNC at earliest convenience |
Pts 2 mos-2 yo with expected clinical response within 2 days: | US at earliest convenient time; VCUG or RNC strongly encouraged |