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Related Concept Videos

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Urinary Tract Infection I: Introduction01:26

Urinary Tract Infection I: Introduction

Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs like...
Disorders of the Urinary System01:20

Disorders of the Urinary System

The urinary system is responsible for eliminating waste and excess fluids from the body. However, disorders of the urinary system can arise due to various reasons like infections, stress, age, congenital abnormalities, and lifestyle.
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...
Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...

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Does this child have a urinary tract infection?

Nader Shaikh1, Natalia E Morone, John Lopez

  • 1Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. nader.shaikh@chp.edu

JAMA
|December 27, 2007
PubMed
Summary

Accurate diagnosis of pediatric urinary tract infection (UTI) is crucial. While individual symptoms like fever or pain aid diagnosis, combining findings is more reliable for identifying UTIs in children.

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Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Diagnostic Accuracy

Background:

  • Urinary tract infections (UTIs) are common in children and can cause permanent kidney damage if untreated.
  • Accurate and timely diagnosis of pediatric UTIs is essential for preventing renal injury.

Purpose of the Study:

  • To systematically review the diagnostic accuracy of various signs and symptoms for identifying UTIs in infants and children.
  • To evaluate the utility of individual and combined clinical findings in UTI diagnosis.

Main Methods:

  • Comprehensive literature search of MEDLINE and EMBASE databases (1966-2007), supplemented by manual reviews of bibliographies, previous systematic reviews, textbooks, and expert consultations.
  • Inclusion criteria focused on studies reporting signs or symptoms of UTI in children up to 18 years of age.
  • Data extraction and quality assessment were performed independently by two evaluators.

Main Results:

  • In infants, fever >40°C, history of UTI, and suprapubic tenderness were significant indicators. Lack of circumcision increased UTI likelihood in males.
  • Combinations of symptoms, such as prolonged fever without another source, improved diagnostic accuracy compared to individual signs.
  • In verbal children, abdominal pain, back pain, dysuria, urinary frequency, and new-onset incontinence were associated with increased UTI likelihood.

Conclusions:

  • Individual signs and symptoms offer some diagnostic value for pediatric UTIs but lack definitive accuracy.
  • Combining multiple clinical findings can effectively identify children with a low probability of UTI, aiding clinical decision-making.