Skip to Main Content


High-Yield Facts


  • Signs and symptoms of urinary tract infection (UTI) may be nonspecific in young infants, and even older children may not complain of dysuria.

  • In the evaluation of infants and children with fever without a source, up to 7% of patients will be found to have a UTI.

  • Urinary catheterization is the method of choice for obtaining the urine specimen in febrile infants and young children.

  • Presence of bacteria on a Gram stain or nitrites and leukocyte esterase on urine dipstick are highly indicative of a UTI, but urine culture is the gold standard for diagnosis.

  • Greater than 5% of infants younger than 3 months with fever and UTI are bacteremic.

  • Antibiotic choice for UTI must be guided by local resistance patterns and effectiveness against Escherichia Coli.

  • Approximately 90% of renal stones are radiopaque and can be managed medically.

  • Computed tomography (CT) scan of the abdomen without contrast is the test of choice for the evaluation of children with renal stones; however, ultrasound may be used to evaluate children with recurrent renal stones.

  • Recurrence rates of urolithiasis are high in children and require a thorough metabolic evaluation for the cause.


Urinary Tract Infection


Urinary tract infection (UTI) is a frequent cause of fever in infants and young children accounting for more than 1.1 million visits annually, and occurring in 2.4% to 2.8% of all children.1,2 It is important to identify and treat UTIs because this may lead to the diagnosis of unsuspected anomalies of the urinary tract, and, thus, the prevention of morbidity associated with progression to pyelonephritis as well as long-term complications of renal scarring such as chronic renal failure and hypertension. Fever may be the sole manifestation of a UTI. Febrile children younger than 24 months with no other identifiable source for fever on examination were found to have a 7% probability of UTI (range <1%–16%), which is higher than the likelihood of occult bacteremia (<1%) among fully immunized children.3,4 The prevalence of UTI varies with age and gender. Studies show a 2- to 3-fold higher risk of UTI in febrile, uncircumcised male infants than age-matched females and a 10-fold greater risk of UTI than circumcised males in the first 3 months of life.4,5 After 3 months of age, febrile female infants have a higher prevalence (2%–10%) of UTIs compared to their male counterparts with circumcised males having less than a 0.5% chance of UTI after 6 months of age.4 Race may also play a role in the incidence of UTI with Whites showing a higher prevalence (8% vs. 2.7%) compared with African Americans.4


Classic symptoms of UTI such as dysuria, urgency, increased urinary frequency, and flank pain are less frequently reported in children than in adults.4 Young children, in particular, are more likely to present with nonspecific symptoms. It is important to identify common risk factors ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.