Urinary Tract Infection

Common

Step 1: View clinicals

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.


Step 2: Order all relevant investigations

Complete Blood Count

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)

Urinalysis + Urine Culture

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.

Renal Ultrasound

The ultrasound scan of the kidneys, ureters and bladder is completely normal.

Voiding Cystourethrography

The voiding cystourethrogram is scheduled for tomorrow.


Step 3: Select appropriate management

Acetaminophen
Co-trimoxazole
Ciprofloxacin
Urology Referral stat


Score: ★★☆