UTIs Flashcards
(11 cards)
Primary source of bacteria for UTIs?
Faeces
Intestinal bacteria such as E coli, klebsiella pneumoniae and enterococci can enter the urethral opening from the anus.
Presentation of UTIs in infants?
Non specific symptoms including fever, lethargy, irritability, vomiting, poor feeding, and urinary frequency.
Signs & symptoms of UTIs in older infants and children?
More specific symptoms including abdominal pain (suprapubic), dysuria, urinary frequency, urinary urgency, urinary incontinence, fever, vomiting, and bedwetting (nocturnal enuresis).
How do you make diagnosis for acute pyelonephritis?
Fever over 38 degrees and loin pain or tenderness.
Management of acute pyelonephritis?
Full septic screen and immediate IV antibiotics. Follow local guidelines and take into account urine culture results when deciding on an antibiotic. Uncomplicated lower UTIs are treated with 3 days of oral antibiotics.
Choices of antibiotics in children?
Trimethoprim, Nitrofurantoin, Cefalexin, Amoxicillin.
When do you do USS for UTIs?
All children under 6 months with their first UTI (within 6 weeks), recurrent UTIs (within 6 weeks), and atypical UTIs (atypical organism, done during the illness).
Explain DMSA scan?
Recommended 4-6 months after the infection to assess for damage from recurrent or atypical UTIs. DMSA is injected and a gamma camera is used to determine how well the kidneys take up the material.
Explain a micturating cystourethrogram?
Used to test for vesicoureteral reflux in infants under 6 months with recurrent or atypical UTIs. Considered if there is a family history of vesicoureteral reflux, dilatation of the ureter, or poor urinary flow. Involves catheterising the child, injecting contrast into the bladder, and taking X rays to see if the contrast is refluxing into the ureters.
What is vesicoureteral reflux?
Involves urine flowing back into the ureters from the bladder. Predisposes patients to developing upper UTIs and renal scarring. Diagnosed using MCUG.
Management of vesicoureteral reflux?
Avoiding constipation, avoiding an excessively full bladder, prophylactic antibiotics, and surgical input from paediatric urology.
