Urinary tract infection (UTI) is a common diagnosis in pediatric patients presenting to the emergency department. Although there are several evidence-based guidelines for UTI, they have small variations that can make the workup and management for UTI challenging.
Our recent issue Management of Pediatric Urinary Tract Infections in the Emergency Department reviews the current state of the literature and best practices for the diagnosis and management of UTI in children presenting to the emergency department, including criteria to help the clinician decide whether to test a patient’s urine, the best method for urine testing based on the clinical scenario, and how to manage the patient based on the results of urine testing.
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Here are a few key points:
- When deciding whether to test and treat patients for urinary tract infection (UTI), consider risk factors, including sex, age, circumcision status, and duration of fever.
- Uncircumcised boys aged <12 months are at high risk for UTI.
- Consider alternative diagnoses to UTI for chief complaints such as dysuria (chemical irritation, foreign body, trauma, epididymitis, vaginitis, sexually transmitted infection, pelvic inflammatory disease), flank pain (nephrolithiasis, retrocecal appendicitis), and urinary incontinence/frequency (bladder and bowel dysfunction, spinal cord compression, diabetes).