Approach to: Pediatric urinary tract infection (UTI)

Urinary tract infections (UTIs) are prevalent in the children. Presentation of UTI vary in children of different ages. In infants, who cannot localize symptoms, UTI can present with a fever whereas in older children a UTI can present with urinary symptoms (dysuria, urinary frequency, incontinence). It is important to establish a clear diagnosis in order to treat and resolve the infection with antibiotics therapy to prevent bacteremia, pyelonephritis, and long-tern renal disease. Urine is collected through a mid-stream urine sample, in toilet trained children, via urethral catheterization, suprapubic aspiration and pediatric urine collection bags. Urine analysis and culture are the first-line investigations in children with suspected UTI. Goals of treatment include elimination of infection, relief of acute symptoms, and prevention of recurrent and long-term complications. The Canadian Pediatric Society recommends initial treatment with oral antibiotics for nontoxic children with febrile UTIs. Imaging, such as a renal/bladder ultrasound, may be used.