UTI and vesicoureteric reflux Flashcards
What is the most common cause of UTI?
E. coli= 85%
What are some other bacterial causes of UTI?
Klebsiella
Proteua
STIs in young sexually active males
What are some predisposing factors for UTI?
Incomplete bladder emptying- infrequent voiding, hurried micturition, obstruction
Vesicoureteric reflux
Poor hygiene
What is the presentation of UTIs in neonates?
Fever
Lethargy, irritability
VOmiting
Smelly and heavy nappies
What is the presentation of UTI in kids?
Fever, malaise, vomiting
Abdo pain/tenderness
Frequency, dysuria, smelly/cloudy urine
What investigations are done for UTI?
Urine dipstick- unreliable in <2yo
Microscopy- pyuria >10
Urine culture >10^5
What are indications for further investigations in UTI?
<6 months
Septic presentation
Recurrent
Upper tract symptoms
What further investigations can be done for UTI?
US
DMSA
Micturating cystourethrogram
What is the management of lower tract UTI?
3 days oral trimethoprim
What is the management of upper tract UTI?
7-10 days oral or IV
- co-amoxiclav
- cephalosporin
- trimethoprim (oral only)
What is vesicoureteric reflux?
Retrograde urine flow
What are the grades of vesicoureteric reflux?
1= ureter only 2= ureter, pelvis, calyces 3= dilatation of ureter 4= moderate dilation of ureter +/- pelvis, tortuous ureter or obliteration of fornices 5= gross dilatation/tortuosity
How does vesicoureteric reflux present?
Recurrent UTIs
What investigations are done for vesicoureteric reflux?
Micturating cystourethrogram
DMSA- looks for scarring
What is the management of vesicoureteric reflux?
Conservative- voiding advice, fluids
Prophylactic antibiotics
Submucosal teflon injection
Ureteric preimplantation
