RT Book, Section
A1 Jara-Almonte, Geoffrey W.
A1 Doniger, Stephanie J.
A2 Tenenbein, Milton
A2 Macias, Charles G.
A2 Sharieff, Ghazala Q.
A2 Yamamoto, Loren G.
A2 Schafermeyer, Robert
SR Print(0)
ID 1155428171
T1 Urinary Tract Diseases
T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259860751
LK accesspediatrics.mhmedical.com/content.aspx?aid=1155428171
RD 2024/04/23
AB Signs  and  symptoms  of  a  urinary  tract  infection  (UTI)  may  be  nonspecific  in  neonates  and  young  infants.Urinary  catheterization  is  the  preferred  method  for  obtaining  a  urine  specimen  in  children  who  are  not  toilet  trained.Sterile  urine  cultures  (via  catheterization  or  suprapubic  aspiration)  should  be  obtained  prior  to  the  administration  of  antibiotics  in  ill-appearing  children  and  neonates.Up  to  9.8%  of  infants  younger  than  3  months  of  age  with  fever  and  UTI  are  also  bacteremic;  blood  cultures  should  be  obtained  in  these  infants.The  antibiotic  choice  for  a  UTI  must  be  guided  by  local  resistance  patterns  and  the  effectiveness  against  Escherichia  coli.Children  with  a  history  of  a  UTI  should  be  cautioned  to  seek  medical  care  in  the  first  48  hours  of  subsequent  febrile  illnesses  to  evaluate  for  a  recurrent  UTI.Approximately  90%  of  renal  stones  are  radiopaque  and  can  be  managed  medically.An  infected  obstructing  urinary  stone  is  a  urological  emergency  that  demands  emergent  urinary  tract  decompression.Computerized  tomography  (CT)  has  traditionally  been  the  imaging  modality  of  choice  for  the  diagnosis  of  renal  stone,  but  an  ultrasound-first  approach  is  increasingly  being  utilized.Recurrence  rates  of  urolithiasis  are  high  in  children  and  therefore  require  a  thorough  metabolic  evaluation  for  the  cause.