Urology - UTI Flashcards
Which gender is UTI more common in?
More common in boys until 3 months
then in girls
Most common causative agent>
Escherichia coli
What is atypical UTI?
Wont respond to ABX within 48 hours
Non E.coli infection -> klebseilla
sepsis, abdominal mass, raised creatinine
What organism is atypical e.coli usually?
Klebsiella
Raised creatinine and UTI?
Atypical UTI
What anatomical thing can cause recurrent / atypical UTIs?
Vesicoureteric reflux - abnormal backflow of urine from bladder into ureters and kidneys
How to diagnose vesicoureteric reflux?
micturating cystourethrogram (MCUG)
Why may a DMSA scan need to be used in children with vesicoureteric reflux?
How to diagnose UTI features in infants <3 months
poor feeding
vomiting
irritability
How to diagnose UTI features in 3 monts - 1 year
Abdominal pain
fever
dysuria
Older children with UTi symptoms?
Dysuria
Frequency
haematuria
How to investigate for UTI?
Urine dipstick (leukocytes + nitrites)
Urine culture (clean catch / MSU urine sample)
nitrites : very specific and suggestive of e.coli
How to manage UTI under <3 months?
Immediate referral to paediatrician after admission
Admit and do a full sepsis screen
urine MC&S + IV abx
Is admission required in children >3 months with uti?
sepsis 6 if unstable
if upper UTI may need paeds referral
Antibiotics for lower UTI?
q
3 days
oral trimethroprim OR nitrofurantoin
ABX for upper UTI?
IV cephalexin for 7-10 days
What will prompt a non urgent USS?
What will prompt an urgent USS?
prophylaxis for atypical recurrent uti?
long term low dose antibiotic prophylaxis
