UTIs in kids

Question 1

diagnosis of acute pylenonephritis is made if

Answer 1

either of

• fever>38
• loin pain or tenderness

Question 2

ideal urine sample

Answer 2

clean catch

Question 3

Mx - < 3mo

Answer 3

IV antib (e.g. ceftriaxone)

septic screen inc blood cultures, lactate

Question 4

Mx - >3mo

Answer 4

oral antib if otherwise well

symptoms sepsis/pyelonephritis = IV antib

Question 5

USS - <6mo

Answer 5

first UTI - USS within 6wks

recurrent UTIs, atypical bacteria = during illness

Question 6

USS - recurrent UTIs

Answer 6

should have USS within 6wks

Question 7

USS - atypical UTI

Answer 7

should have USS during illness

Question 8

DMSA scan

Answer 8

should be used 4-6mo after illness to asses for damage from recurrent or atypical UTI

scarring

Question 9

Vesico-ureteric reflux

Answer 9

urine flows from bladder back into ureters

predisposes patient to upper UTIs and subsequent renal scarring

Question 10

VUR - Ix

Answer 10

micturating cytourethrogram

Question 11

VUR - Mx

Answer 11

depends on severity

avoid constipation
avoid excessively full bladder
prophylactic antib
surgical input

Question 12

MCUG - when

Answer 12

should be used to Ix atypical or reccurent UTI in kids <6mo

also if FHx VUR, dilation of ureter on USS or poor urinary flow