UTIs Flashcards
What is the most common cause of UTI in paediatrics?
Bacterial - E. coli
What is the difference between pathophysiology of UTIs in neonates versus older children?
- Neonates - bacteria reach urinary tract via blood stream
2. Older children - ascend urinary tract from perineum
At what point do UTIs become more common in girls than boys?
At 3 months of age
What are the risk factors for developing a UTI?
- VUJ obstruction
- Incomplete bladder emptying (constipation, infrequent voiding)
- Poor hygiene - advise wiping front to back
What is this a presentation of?
<4 years old, fever, vomiting, poor feeding, lethargy, crying.
UTI
What is this a presentation of?
>4 years old, dysuria, frequency, loin/abdominal pain, incontinence, fever, vomiting.
UTI
How is a UTI diagnosed in a child >3 years old?
- Clean catch urine
2. Positive WCC and nitrates
How is a UTI diagnosed in a child <3 years old?
- Clean catch urine
2. Dip for WCC and nitrates, also need urine MCS.
What should you exclude in a recurrent/atypical UTI in a child <6 months and how?
Reflux, with MCUG
What is the next step in these scenarios of a child with a suspected UTI?
- Leucocytes +, nitrates +
- L -, N+
- L+, N-
- L-, N-
- Start antibiotics
- Start antibiotics
- Await MCS before antibiotics
- No antibiotics
What do all children <6 months with their first UTI need and why?
- USS
2. VUJ reflex, posterior valves, PKD
What is the general management for children with a UTI?
- Avoid constipation, increase oral fluids
- Encourage full voiding and void twice
- Treatment antibiotics
- Prophylactic antibiotics for VUJ reflux
What antibiotics are given to a child <3 months old with a UTI who is systemically unwell?
IV amoxicillin and gentamicin
What antibiotics are given to a child >3 months old with a lower UTI?
3 days trimethoprim/nitrofurantoin/amoxicillin
What antibiotics are given to a child >3months old with an upper UTI?
Admit, 7 days PO/IV trimethoprim/nitrofurantoin/amoxicillin
