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Pediatric urinary tract infection: does the evidence support aggressively pursuing the diagnosis?

Abstract：

:The epidemiology of pediatric fever has changed considerably during the past 2 decades with the development of vaccines against the most common bacterial pathogens causing bacteremia and meningitis. The decreasing incidence of these 2 conditions among vaccinated children has led to an emphasis on urinary tract infection as a remaining source of potentially hidden infections in febrile children. Emerging literature, however, has led to questions about both the degree and nature of the danger posed by urinary tract infection in nonverbal children, whereas the aggressive pursuit of the diagnosis consumes resources and leads to patient discomfort, medical risks, and potential overdiagnosis. We review both early and emerging literature to examine the utility and efficacy of early identification and treatment of urinary tract infection in children younger than 24 months. We conclude that in well children of this age, it may be reasonable to withhold or delay testing for urinary tract infection if signs of other sources are apparent or if the fever has been present for fewer than 4 to 5 days.

journal_name

Ann Emerg Med

journal_title

Annals of emergency medicine

authors

Newman DH,Shreves AE,Runde DP

doi

10.1016/j.annemergmed.2012.10.034

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

559-65

issue

5

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(12)01707-6

journal_volume

61

pub_type

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