UTIs & Bed wetting Flashcards
How would you expect a UTI to present in an infant or child?
neonates will have fever, vomiting, lethargy & irritability (basically non-specific signs)
Children will also complain of abdo/loin pain & tenderness
Along with dysfunctional voiding
How do you test for UTI?
Try to get a clean catch urine or midstream urine sample (otherwise a catheter sample or suprapubic aspiration)
- Dipstix (leucocyte/nitrites)
- Microscopy (Pyuria/bacteria)
- Culture(>10^5 colony forming units)
What organisms cause UTI in kids?
Most E.coli
In what cases of a childhood UTI would you go looking for an underlying cause and how?
- Atypical presentation (e.g. upper tract)
- Young (<6months)
- Recurrent
- Atypical bugs
US for structure & Micturating Cystourethrogram for VUR
What scans can you do to check renal scarring/structure?
US for structure
DMSA for scarring
MAG3 (not good in young kids as need continence and to follow instruction)
How do you go about treating a UTI in a kid?
Lower tract = 3 days trimethoprim or co-amoxiclav
Upper tract = 7-10 days (IV if systemically unwell)
What can you do to prevent further UTIs?
Educate on hygiene and hydration
Look for abnormal tract e.g. VUR
Treat constipation early
How would you manage VUR if you found it?
Educate on fluids, hygiene and constipation management
Trimethoprim prophylaxis till 5
STING procedure or Ureteric Reimplantation