A 3 year and 6 month old girl presents with mild fever and diffuse abdominal pain for 1 day, in association with 2 episodes of vomiting. She now complains of dysuria as well. She was completely healthy earlier, with unremarkable medical and surgical histories. Her developmental milestones are age appropriate. All immunizations are up to date.
WBC: 10,600/mm3 (5,500-15,500) N: 50% L: 40% M: 6% E: 2% Hb: 12.3 g/dL (11.5-13.5) Hct: 38% (34-40) Plt: 277,000/mm3 (150,000-450,000)
Color: yellow RBCs: nil Leukocytes: 20-30/hpf Casts: none Protein: normal Glucose: normal Organisms: + Leucocyte esterase: positive Nitrates: positive A clean catch sample of urine was sent for culture; results will be available in 18 hours.
The ultrasound scan of the kidneys, ureters and bladder is completely normal.
The voiding cystourethrogram is scheduled for tomorrow.