(BQ) Continued part 1, part 2 of the document Paediatric surgery in clinical has contents: Abnormalities of the neck and face, abnormalities of the neck and face, inflammatory bowel disease, the child with an abdominal mass, urinary tract dilatation,. and other contents. Invite you to refer. | Paediatric surgery in clinical: Part 2 PART V Urinary Tract C h apt er 3 1 Urinary Tract Infection Case 1: Case 2: Stacey is a 5-year-old girl who presents with dysuria, pyrexia and Thomas is 6 months old and presents with fever, lethargy and haematuria. There is no relevant past history. smelly, turbid urine. He is not gaining weight. Q What investigations should be done? Q How would a urinary tract infection (UTI) be confirmed? Q What is the likelihood of an underlying urinary tract Q What tests are needed to document a possible urinary tract anomaly? anomaly? Q If there is no urinary tract anomaly, why has the infection occurred? A UTI is best defined as the symptomatic occurrence of The diagnosis of a UTI is further supported by the pathogenic microorganisms, usually bacteria, in the detection of white blood cells (WBCs) in the urine urinary tract. It is a common cause of illness in infants (>5 × 106/L in boys and >40 × 106/L in girls). But this is and children, may herald an underlying urinary tract not a prerequisite for the diagnosis. Children on immu- anomaly and may be associated with the occurrence of nosuppressant therapy may not be able to produce an renal scarring and subsequently the development of immune response, and some infants with overwhelming hypertension. UTIs are commonly misdiagnosed in chil- sepsis may have bone marrow suppression. WBCs can dren. Dysuria and the passage of cloudy urine are also be found in the urine of patients without a UTI such common symptoms in children with a febrile illness and as those with intra-abdominal infection (. appendi- do not necessarily reflect UTI. On the other hand, many citis) and other pyrexial illnesses; however, there will children with a UTI have non-specific symptoms or have not be a significant bacteriuria. unexplained fever, vomiting or even failure to thrive: in these patients, the diagnosis may be .
