1 / 19

Understanding UTIs in Children: Risk Factors, Symptoms, and Treatment Approaches

This report provides a comprehensive overview of urinary tract infections (UTIs) in children, detailing risk factors, common symptoms, and effective treatment options. It highlights the differences between lower and upper UTIs, including cystitis and pyelonephritis. Emphasis is placed on age-related risk factors, diagnostic methods, and the role of common pathogens like E. coli. The report also discusses treatment protocols for cystitis and pyelonephritis, emphasizing the importance of follow-up care and management of potential complications.

norton
Télécharger la présentation

Understanding UTIs in Children: Risk Factors, Symptoms, and Treatment Approaches

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Morning Report September 6, 2011

  2. UTIs • Lower • Bladder • Urethra • Upper • Kidneys • Renal pelvis • Ureters

  3. Risk Factors • Age • Infants • Teenagers • Sex • First 3 postnatal months • Males • First 6 years • Females

  4. Risk Factors • Previous history • Sibling with UTI • Catheterization • Structural Abnormalities • Cause complicated UTIs • Most important risk factor for the development of pyelonephritis?? • VUR

  5. Common Bugs • E.coli • 90% • Enterobacter • Proteus • Klebsiella

  6. Defense • Empty bladder regularly

  7. Signs and Symptoms • Younger children and infants • Fever • Irritability • Poor feeding • Lethargy • Abd pain • Vomiting • Loose stools

  8. Signs and Sypmtoms • Older children/adolescents • Cystitis: consist of dysuria, frequency, urgency, suprapubic pain, and/or hematuria • Pyelonephritis:consist of the above symptoms (symptoms of cystitis may or may not be present) together with fever (>38ºC), chills, flank pain, costovertebral angle tenderness, and nausea/vomiting • May mimic PID

  9. To Bag or Not to Bag? • Bag specimen • Bag can only exclude if normal, although in younger kids, they may still have UTI and have normal UA • Urethral catheterization • Suprapubic aspiration • Clean Catch • Older children

  10. Results • Leukocyte esterase • WBCs • Casts are diagnostic of pyelonephritis • Nitrites • Bacteria • Gram stain

  11. Results • Pyelonephritis • Elevated peripheral WBC count • ESR • CRP • None are sensitive or specific enough to include or exclude

  12. Results • Culture results • Diagnostic confirmation • Suprapubic tap • Any growth • Cath • >50,000 • Midstream Catch • >100,000

  13. Imaging • Not needed to confirm diagnosis of pyelo! • U/S • CT • More sensitive • DMSA • Test of choice • Detects renal scarring • Not routinely used

  14. Treatment • Cystitis • Nitrofurantoin • *Avoid if suspected early pyleonephritis due to poor plasma concentration • TMP-SMX • Do not use if local resistance is over 10-20% • Fluoroquinolones

  15. Treatment • Pyleonephritis

  16. Treatment

  17. Follow up • No f/u culture needed • < 5 years old • Antibiotics until work up complete • Renal U/S • VCUG • Older children may warrant eval if febrile UTI or pyelonephritis occurs

  18. Complications • Bacteremia • Obstruction • Abscess • Recurrence • Renal Scarring • HTN

  19. Noon Conference Basics of Clinical Teaching, Dr. English Students off!

More Related