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American Academy of Pediatrics
Article

Urinary Tract Infections in Children

Eric Balighian and Michael Burke
Pediatrics in Review January 2018, 39 (1) 3-12; DOI: https://doi.org/10.1542/pir.2017-0007
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Eric Balighian
*St Agnes Hospital, Baltimore, MD
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Michael Burke
*St Agnes Hospital, Baltimore, MD
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  1. Eric Balighian, MD*
  2. Michael Burke, MD*
  1. *St Agnes Hospital, Baltimore, MD
  • AUTHOR DISCLOSURE

    Dr Balighian has disclosed no financial relationships relevant to this article. Dr Burke has disclosed that he serves as a section editor for Contemporary Pediatrics, a monthly publication by UBM Medica, and receives a stipend for this activity. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

  • Abbreviations:
    AAP:
    American Academy of Pediatrics
    CFU:
    colony-forming unit
    DMSA:
    dimercaptosuccinic acid
    IV:
    intravenous
    UTI:
    urinary tract infection
    VCUG:
    voiding cystourethrogram
    WBC:
    white blood cell
  • Educational Gaps

    Consideration of risk factors for urinary tract infections (UTIs) in young children with fever is critical for accurate diagnosis, as well as prevention of overtesting. The use of perineal bags to collect urine from young children should be limited to specific indications in the diagnosis of UTIs. Screening for and managing bowel and bladder dysfunction reduces the risk of UTIs in older children.

    Objectives

    After completing this article, readers should be able to:

    1. Recognize the risk factors for urinary tract infections (UTIs) in children.

    2. Review the interpretation of urinalysis and urine cultures.

    3. Review antibiotic therapy choices for UTIs.

    4. Describe which children need imaging after febrile UTIs.

    5. Discuss prevention strategies to discuss with families.

    Case Study

    Charlotte is a 13-month-old girl with a history of 2 febrile urinary tract infections (UTIs) 4 and 6 months ago. She had normal renal and bladder ultrasonographic findings 6 months ago. She presents with a fever that began yesterday. She has no other new symptoms. Her 4-year-old brother had a self-limited febrile illness 1 week ago, which resolved. At examination, she is fussy but consolable and alert. She is non–toxic appearing. Her physical examination findings show tachycardia with a heart rate of 130 beats/min, without murmur. Her respiratory rate is 28 breaths/min, without distress or retractions. Her lungs are clear bilaterally. Her tympanic membranes appear normal. Her abdomen is soft and nontender. Her genital examination findings appear normal, without erythema or labial adhesions. Her temperature is 102.5°F (39.2°C). A bag is placed …

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    Pediatrics in Review: 39 (1)
    Pediatrics in Review
    Vol. 39, Issue 1
    1 Jan 2018
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    Urinary Tract Infections in Children
    Eric Balighian, Michael Burke
    Pediatrics in Review Jan 2018, 39 (1) 3-12; DOI: 10.1542/pir.2017-0007

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    Urinary Tract Infections in Children
    Eric Balighian, Michael Burke
    Pediatrics in Review Jan 2018, 39 (1) 3-12; DOI: 10.1542/pir.2017-0007
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