CLIPP 10 - UTI

Question 1

DDX infant fever (9)

Answer 1

• UTI
• pneumonia
• sepsis/bacteremia
• occult bacteremia
• bacterial meningitis
• viral meningitis
• roseola
• primary HSV gingivostomatitis
• otitis media
• viral URI

Question 2

Fever without a source causes

Answer 2

• viral syndrome
• Serious Bacterial illness (UTI, meningitis, sepsis/bacteremia, pneumonia, bacterial gastroenteritis, osteomyelitis, septic arthritis)

Question 3

Meningitis signs in infants (11)

Answer 3

• fever, hypothermia, bulging fontanelles, lethargy, irritability, restlessness, paroxysmal crying, poor feeding, vomiting, diarrhea
• +/- meningeal signs

Question 4

FWS testing (4)

Answer 4

• UA
• CBC with diff
• blood culture
• LP

Question 5

inpatient vs outpatient UTI treatment

Answer 5

IV antibiotics if patient is toxic, unable to retain oral medications, concern or compliance

Question 6

UTI abx (4 IV, 4 oral)

Answer 6

IV: ampicillin/gentamicin, ceftriaxone, meropenem, ciprofloxacin
Oral: cephalexin, TMP/SMX, nitrofurantoin, augmentin

Question 7

UTI imaging (3)

Answer 7

• US (Structure/dilations)
• Renal technetium scan (pyelonephritis)
• Voiding cystourethrogram (vesicoureteral reflux

Question 8

When do kids get fevers after vaccines?

Answer 8

• inactivated: 2-3days

- live attenuated: 6-14days

Question 9

Bacterial vs viral meningitis CSF findings

Answer 9

Bacterial: low glucose, elevated protein, elevated WBC (PMNs), gram stain +/-
Viral: normal glucose, normal/elevated protein, elevated WBC (Lymphs), negative gram stain