Pediatric UTI's

Question 1

What are the signs/symptoms of a child suspected to have a UTI?

Answer 1

iF <2 years old:
Fever is usually the only symptom.
Also may have poor feeding/growth, be irritable, have abdominal pain.

If >2 years old:
Fever, dysuria, high urninary frequency , urgency.
If fever ,chills, flank pain, vomiting suspect Pyelonephritis.

Question 2

How to diagnose UTI in pediatrics?

Answer 2

Urine dipstick, urine culture.

Nitrites (for G- bact).

WBC casts indicate pyelonephritis.

○ UTI can be sign of diabetes, poor hygiene, sexual activity.
○ Recurrent UTI may be sign of anatomical abnormalities/obstruction.

Question 3

How to treat UTI in pediatrics?

Answer 3

■ Uncomplicated: Oral antibiotics TMP-SMX, nitrofurantoin
● Cystitis typically lasts ~3-5 days

■ Complicated/Severe UTI: IV antibiotics 3rd gen cephalosporins,
aminoglycosides.
● Pyelonephritis lasts ~10-15 days