UTI
Prereading :
| NICE UTI Guideline |
Workbook Questions :
Case 1 :
A 5-year-old girl presents to ED with pain when she passes urine, her symptoms started this morning and mum noticed she also felt hot. She has a temp of 38.2 but otherwise normal observations and examination
Case 2
A 5-month-old baby presents with high fevers and vomiting for 48 hours. There are no other focal symptoms or signs on exam and you are worried about a urinary tract infection.
A 15-year-old girl presents with pain on urination and fevers and wonders whether she has a UTI. On arrival she is febrile and flushed with a HR of 110.
- Can you list some risk factors for UTI?
- How does a child under 6 months with a UTI present to ED, what type of symptoms might they have?
Case 1 :
A 5-year-old girl presents to ED with pain when she passes urine, her symptoms started this morning and mum noticed she also felt hot. She has a temp of 38.2 but otherwise normal observations and examination
- How will you collect her urine and how will you advise her and her mum to do this?
- Will you dipstick her urine or just send it to the lab for testing?
- What will you look for on the urine results to suggest she has a UTI?
- If she has a UTI on microscopy what will be your choice of antibiotics? Dose? And route of administration?
- Does she require any follow up or further investigations?
Case 2
A 5-month-old baby presents with high fevers and vomiting for 48 hours. There are no other focal symptoms or signs on exam and you are worried about a urinary tract infection.
- How will you collect the urine from this baby?
- The observations reveal a HR 170, Temp 38.4, RR 44. He is still vomiting. The urine is positive for infection, how will you treat this boy including dose, route of administration of any drugs and disposition?
A 15-year-old girl presents with pain on urination and fevers and wonders whether she has a UTI. On arrival she is febrile and flushed with a HR of 110.
- What further questions would you ask in this age group to determine the cause and also the risks?
- On examination she has tenderness in her R flank, will this change your management?
- After her mother leaves the room she states she has recently had unprotected intercourse. Her LMP was 3 weeks before but she has noticed some PV discharge in the last couple of days. Would this change your management? Will you talk to her mother about this?