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    Ii. Algorithm: Suspected Urinary Tract Infection History

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    Taeyomi
    This document outlines the algorithm for diagnosing and treating a suspected urinary tract infection in children. It describes collecting a urine sample via suprapubic tap or catheterization for infants and midstream collection for older, cooperative patients. A positive urinalysis with leukocyte esterase or nitrite suggests a UTI. For confirmed UTIs, treatment options include oral or intravenous antibiotics based on urine and blood test results, with follow-up based on the patient's response. Further testing and urology consultation may be needed in some cases.

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    Ii. Algorithm: Suspected Urinary Tract Infection History

    Uploaded by

    Taeyomi
    17 views6 pages
    This document outlines the algorithm for diagnosing and treating a suspected urinary tract infection in children. It describes collecting a urine sample via suprapubic tap or catheterization for infants and midstream collection for older, cooperative patients. A positive urinalysis with leukocyte esterase or nitrite suggests a UTI. For confirmed UTIs, treatment options include oral or intravenous antibiotics based on urine and blood test results, with follow-up based on the patient's response. Further testing and urology consultation may be needed in some cases.

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    UTI

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    This document outlines the algorithm for diagnosing and treating a suspected urinary tract infection in children. It describes collecting a urine sample via suprapubic tap or catheterization for infants and midstream collection for older, cooperative patients. A positive urinalysis with leukocyte esterase or nitrite suggests a UTI. For confirmed UTIs, treatment options include oral or intravenous antibiotics based on urine and blood test results, with follow-up based on the patient's response. Further testing and urology consultation may be needed in some cases.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    17 views6 pages

    Ii. Algorithm: Suspected Urinary Tract Infection History

    Uploaded by

    Taeyomi
    This document outlines the algorithm for diagnosing and treating a suspected urinary tract infection in children. It describes collecting a urine sample via suprapubic tap or catheterization for infants and midstream collection for older, cooperative patients. A positive urinalysis with leukocyte esterase or nitrite suggests a UTI. For confirmed UTIs, treatment options include oral or intravenous antibiotics based on urine and blood test results, with follow-up based on the patient's response. Further testing and urology consultation may be needed in some cases.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 6

    II.

    ALGORITHM
    SUSPECTED URINARY TRACT INFECTION

    HISTORY URINALYSIS
    (SUGGESTIVE OF UTI)

    P.E. (+) Leukocyte esterase or


    Nitrite test
    (+) Urine culture

      FEVER 38.5 DEGREES CELSIUS

    ABSENT PRESENT
    CBC (CRP, ESR)
    BUN, Creatinine
    Optimal CRP, ESR, Blood C&S

    • Admit to Hospital
    Oral antibiotics KUB, • Parenteral Antibiotics (IV,IM)
    UTZ, pre and post void • KUB, UTZ, pre and post void
    • Urology consult as needed

    Good response Poor response Good response


    After 48-72 hours After 48-72 hours After 48-72 hours

    • Reassess
    Complete 7-14 days of • Repeat urine culture May shift to oral antibiotics
    treatment • Use appropriate antibiotics based on Complete 7-14 days
    initial urine C&S (if available)
    • Complete 7-14 days of treatment
    Antibiotic prophylaxis

    Renal work up: Voiding Cystourethrogram *


    or nuclear cystogram
    When needed: Radionuclide renal scan (DMSA/DTPA)
    Intravenous pyelography **
    Other imaging techniques **

    Urology follow-up as needed

    Nephrology ff. up
    Monitor Blood Pressure
    Urinalysis every (4-6 weeks)
    Urine Culture
    GFR (Creatinine)

    ** Timing depends on discretion of the specialist


    *Usually done two weeks after completion of treatment
    III. DIAGNOSIS
    HISTORY
    History of previous proven UTI, constipation, voiding disorders such as
    incontinence, previous surgeries especially pelvic surgeries, ambulatory problem
    etc.

    PHYSICAL EXAMINATION
    Look for congenital defects that coexists.
    Back examination: dimples, hair tufts in the lumbosacral area indicating probable
    neurogenic bladders
    Lower extremities: examined
    Neurologic examination
    Rectal Examination

    URINALYSIS
    Foundation by which every child with suspected urinary tract infection would either
    have further work-up or put aside for observation.
    PROPER COLLECTION OF URINE

    Requirements

    1. For infants below one year of age, suprapubic tap is


    recommended
    2. A catheterized urine is a good alternative to obtain
    urine specimen
    3. Midstream urine collection for cooperative patients-
    older girls, circumcised boys and older boys whose
    foreskin is easily retracted
    CAVEAT

    • Parallel combinations of test results maximize


    sensitivity.
    • A study within one of urine collection using careful
    on site microscopy with positive combination for
    leukocytes and bacteria has a sensitivity of 99% or
    greater
    • (+) LE, nitrite, blood, proteins, microscopy for
    leukocytes, microscopy of bacteria and the
    urinalysis is considered positive—sensitivity 100%
    but specificity is only 60%.

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