UTI in children and adolescents Flashcards

1
Q

Urinalysis and urine culture

A

Criteria for diagnosis includes both a positive urinalysis (pyuria and/or bacteriuria) and urine culture (> 50,000 CFU/mL).

A clean-catch urine sample may be obtained if the child is toilet trained. If not trained, a straight catheterization is necessary.

Indicated in patients with suspected UTI that fulfill one of the following criteria:
1.Females and uncircumcised males of < 24 months of age with one of the following risk factors: either fever of unknown source or of duration > 24 hours, history of UTI, ill appearance, suprapubic tenderness, or nonblack race

  1. Circumcised boys < 24 months of age with at least two of the above risk factors
  2. Children older than 24 months with a suspected UTI based on urinary symptoms
  3. Any febrile infant or child with an abnormal urinary tract or family history of urinary tract disease
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2
Q

Renal and bladder ultrasound

(sotto i 24 mesi, una UTI confermata in urinocoltura richiede ecografia pelvica. Questo perchè ci può essere il rischio di alterazione anatomica delle vie urinarie)

A

Indicazioni

  1. Infants aged 2–24 months with a febrile UTI
  2. Children with either treatment failure, abnormal voiding, abdominal mass, recurrent UTI, or poor likelihood of follow-up

Voiding cystourethrography (VCUG) indicated in abnormal ultrasound (hydronephrosis, obstruction, scarring, or masses), abnormal voiding pattern, or recurrent UTI

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3
Q

Trattamento

A
  • First-line: second- or third-generation cephalosporin (cefdinir, cefixime, cefpodoxime)
  • Alternative: TMP-SMX, first-generation cephalosporin

Trattamento IV nei soggetti sotto i 6 mesi o sempre in uno stato settico o che non possono assumere liquidi per via orale. Al di sopra dei 6 mesi il trattamento è orale
Amoxicillina-acido clavulanico, Cefalosporina 3 generazione (no ceftriaxone)

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