Urinary tract infections in children

Question 1

Presenting symptoms and signs in infants and
children with UTI
Younger than 3 months:
(non specific)

Answer 1

fever, vomiting, lethargy,
irritability, poor feeding, failure to thrive, abdominal
pain, jaundice, haematuria, offensive urine

Question 2

Presenting symptoms and signs in infants and

children with UTI3 months or older and preverbal: non specific

Answer 2

fever, vomiting, lethargy,
irritability, poor feeding, failure to thrive, abdominal
pain, jaundice, haematuria, offensive urine

Question 3

Presenting symptoms and signs in infants and

children with UTI 3 months or older and verbal:

Answer 3

frequency, 
dysuria,
dysfunctional voiding, changes to continence,
abdominal pain, haematuria,
offensive or cloudy urine

Question 4

etio of uti in children

Answer 4

90% is Escherichia coli

girls – 75-90% - Escherichia coli, followed by Klebsiella

boys – 50 % Proteus and 50% Escherichia coli

Question 5

which pathogen causes hemorrhagic cystitis

Answer 5

Adenovirus

Question 6

RF for paed uti

Answer 6

Previously suggested or confirmed UTI

Recurrent fever of uncertain origin

Antenatally-diagnosed renal abnormality

Family history of vesicoureteric reflux or renal disease

Constipation

Dysfunctional voiding

Enlarged bladder

Abdominal mass

Evidence of spinal lesion

Poor growth

High blood pressure

Question 7

classification of paed UTI

Answer 7

pyelonephritis
-inflam of parenchyma

cystitis
-bladder infec

non symptomatic bacteruria

• positive micro but no symps
• esp in girls w/ enurisis (invol urination)

Question 8

reccurent UTI definition

Answer 8

1. One episode of UTI with acute pyelonephritis/upper urinary
   tract infection plus one or more episodes of UTI with
   cystitis/lower urinary tract infection,
2. 2+ episodes of UTI with acute
   pyelonephritis/upper urinary tract infection,
3. Three or more episodes of UTI with cystitis/lower urinary
   tract infection

Question 9

atypical UTI

Answer 9

Infection with non-E. coli organisms.

no Abiotic response in w/in 48 hrs

Septicaemia

Question 10

when to use imaging below 6 mo

Answer 10

US during infection
-atypical / reccurent UTI

US in 6wks if pt responds to rx

-MCUG
reccurent/ atypical UTI

Question 11

when to use imaging above 6 mo

below 3 yrs

Answer 11

acute infec US
-atypical UTI only

US in 6wksd
-reccurent uti only

NO MCUG

Question 12

AB rx of pyelonephritis (upper urinary tract)

Answer 12

oral cephalosporin or

co-amoxiclav, for 7-10 days

Question 13

AB rx of Cystitis/lower urinary tract infection

Answer 13

oral amoxicillin may be suitable for 3 days