Urinary Tract Infections

Question 1

Risk factors for UTIs

Answer 1

Incomplete emptying

Vesicoureteric reflux

Poor hygiene

Question 2

Causes of incomplete bladder emptying

Answer 2

Infrequent voiding

Hurried micturition

Obstruction by full rectum due to constipation

Neuropathic bladder

Question 3

What is vesicoureteric reflux?

Answer 3

Developmental anomaly found in ~35% children who present with a UTI

Question 4

Aetiology of UTIs in paediatrics

Answer 4

E. coli (~80%)

Proteus

Pseudomonas

Question 5

Clinical features of UTIs in babies

Answer 5

Very non-specific symptoms

Fever

Lethargy

Irritability

Vomiting

Poor feeding

Urinary frequency

Question 6

Clinical features of UTIs in older infants & children

Answer 6

More specific

Fever

Abdominal pain, particularlysuprapubic pain

Vomiting

Dysuria(painful urination)

Urinary frequency

Incontinence

Question 7

What might be the only presenting complaint in a child with a UTI?

Answer 7

Fever

Question 8

Investigations for UTIs in children

Answer 8

Urine dip if signs/symptoms of UTI or fever >38

Question 9

Treatment of UTI in infants

Answer 9

Refer immediately paediatrician

Question 10

Treatment of children >3 months with upper UTI

Answer 10

Consider admission

If not admitted give oral abx e.g. cephalosporin/co-amoxiclav for 7-10 days

Question 11

Treatment of children >3 months with lower UTI

Answer 11

Treat with abx for 3 days (usually trimethoprim, nitrofurantoin, cephalosporin or amoxicillin)

Question 12

Investigations for children with recurrent UTIs

Answer 12

Investigate for underlying cause and renal damage

Abdominal ultrasound