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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...
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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...
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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...
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¿Tiene este niño una infección del tracto urinario?

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
Resumen

El diagnóstico preciso de la infección pediátrica del tracto urinario (ITU) es crucial. Si bien los síntomas individuales como la fiebre o el dolor ayudan en el diagnóstico, la combinación de los hallazgos es más confiable para identificar infecciones urinarias en niños.

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Área de la Ciencia:

  • Nefrología Pediátrica.
  • Enfermedades infecciosas Enfermedades infecciosas.
  • Precisión en el diagnóstico.

Sus antecedentes:

  • Las infecciones del tracto urinario (ITU) son comunes en los niños y pueden causar daño renal permanente si no se tratan.
  • El diagnóstico preciso y oportuno de las infecciones urinarias pediátricas es esencial para prevenir la lesión renal.

Objetivo del estudio:

  • Revisar sistemáticamente la precisión diagnóstica de varios signos y síntomas para identificar infecciones urinarias en bebés y niños.
  • Evaluar la utilidad de los hallazgos clínicos individuales y combinados en el diagnóstico de ITU.

Principales métodos:

  • Búsqueda exhaustiva de la literatura de las bases de datos MEDLINE y EMBASE (1966-2007), complementada por revisiones manuales de bibliografías, revisiones sistemáticas anteriores, libros de texto y consultas con expertos.
  • Los criterios de inclusión se centraron en los estudios que informan signos o síntomas de ITU en niños de hasta 18 años de edad.
  • La extracción de datos y la evaluación de la calidad fueron realizadas de forma independiente por dos evaluadores.

Principales resultados:

  • En los bebés, la fiebre >40°C, los antecedentes de infección urinaria y la sensibilidad suprapubiana fueron indicadores significativos. La falta de circuncisión aumentaba la probabilidad de infecciones urinarias en los hombres.
  • Las combinaciones de síntomas, como fiebre prolongada sin otra fuente, mejoran la precisión del diagnóstico en comparación con los signos individuales.
  • En los niños verbales, el dolor abdominal, el dolor de espalda, la disuria, la frecuencia urinaria y la incontinencia de nueva aparición se asociaron con una mayor probabilidad de ITU.

Conclusiones:

  • Los signos y síntomas individuales ofrecen algún valor diagnóstico para las infecciones urinarias pediátricas, pero carecen de precisión definitiva.
  • La combinación de múltiples hallazgos clínicos puede identificar efectivamente a los niños con una baja probabilidad de ITU, ayudando a la toma de decisiones clínicas.