UTI Flashcards
symptoms of UTI in a baby?
- cloudy urine
- irritability
- frequency
- n+v
- jaundice
- febrile convulsions
- haematuria
- failure to thrive
symptoms of UTI in an older child?
- frequency
- pain
- bedwetting (recurrence of enuresis)
- fever/ lethargy/ vomitting
what might you see in examination?
- flank tenderness
- observations (temp going off etc)
- feel the bladder
- spinal abnormalities e.g. spina bifida can cause UTI
what investigations?
how do you get a urine sample, give 4 examples?
- use a clean catch technique (clean dick or any first) (1st line)
- bag or pad (2nd line)
- suprapubic (3rd)
What happens if nitrite positive and leukocyte negative?
The other way around?
how is the urine treated?
- nitrites more important than leukocytes so treat
- based on clinical judgement
- MC and S
how many colony forming units are enough for a UTI?
what is the most common cause? and if it is not that then what does this prompt?
- 10^5
- E.coli
- investigations for anatomical problems
why can’t you give tetracyclines in childhood?
- can cause dental problems, so avoid giving doxycycline in a child
what can be a contributing factor? (3)
- incomplete bladder emptying ( posterior valves)
- vesicoureteric reflux
- neuropathic bladder
(presents of oligohydramnios on a scan)
when would you need to investigate further?
- abnormal organism causing UTI
- <3 months
- atypical UTI (deranged U and Es, abdominal mass, seriously ill)
- recurrent UTI (2+ upper UTIs, 1 upper, 1 lower or 3x lower)
if a child is under 6 months with a UTI what extra investigation do you do?
what other investigations are there and what do they look for?
- ultrasound
- DMSA (checks for scarring)
- MCUG (looks for reflux)
what can ongoing infections cause?
what does VUR cause?
- scarring and hence hypertension
- only upper UTIs
what is the definition of a recurrent UTI?
- 2 upper UTI
- 3+ lower UTI
- 1 upper and 1 lower
what features would indicate an atypical UTI?
- septicaemia
- poor urine flow
- presence of abdominal or bladder mass
- lack of response within 48 hours to treatment
- unusual causative organism
- increased serum creatinine
what renal causes are there for UTI?
- PCKD
- ectopic kidney
- solitary kidney
what non urological causes are there?
- constipation (causes poor bladder emptying)
- neuropathic bladder (spinal cord defect can impair continence and cause infection)
- poor hygiene (wiping back to front)
