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Urinary Tract Infection, Pediatric

Mercedes M. Blackstone, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Urinary tract infection (UTI) is defined by having pyuria and ≥50,000 CFUs/mL of a single urinary tract pathogen from an appropriately collected specimen.

  • Upper tract infection or pye...

DIAGNOSIS

HISTORY

  • Babies

    • Nonspecific symptoms, often fever alone

    • Can have vomiting, irritability, poor feeding, and lethargy

    • Rarely, failure to thrive or jaundice

  • Older children

    • Classic symptoms of the lowe...

TREATMENT

MEDICATION

First Line

  • Empiric antibiotic therapy should be initiated in febrile children with suspected UTI in order to prevent scarring.

  • E. coli is the most common pathogen associated with fir...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Consider a repeat urine culture after 2 days of therapy if the patient is not improving on an appropriate antibiotic regimen.

  • Such patients shoul...

ADDITIONAL READING

  • Gorelick MH, Shaw KN. Clinical decision rule to identify young febrile young girls at risk for urinary tract infection. Arch Pediatr Adolesc Med.  2000;154(4):386–390. [View Ab...

CODES

ICD9

  • 599.0 Urinary tract infection, site not specified

  • 590.80 Pyelonephritis, unspecified

  • 595.9 Cystitis, unspecified

  • 597.80 Urethritis, unspecified

  • 996.64 Infection and inflammatory reaction due to ...

FAQ

  • Q: Which children should have a radiologic evaluation after a UTI?

  • A: Boys; febrile children <2 years, and anyone with recurrent febrile UTIs, hypertension, or family history of urinary tract ab...

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