View stunning SlideShares in full-screen with the new iOS app!Introducing SlideShare for AndroidExplore all your favorite topics in the SlideShare appGet the SlideShare app to Save for Later — even offline
View stunning SlideShares in full-screen with the new Android app!View stunning SlideShares in full-screen with the new iOS app!
Recurrent Urinary Tract Infections Dr. Mehul A. Shah M.D.(Ped.), DCH (Bom.), M.D.(USA) Diplomate of Am Board of Ped. Nephrology Consultant Pediatric Nephrologist Rainbow Children’s Hospital Hyderabad
“ A lecture is the transfer of information from the lecturer’s notes to the student’s notes without passing thru the brains of either”
“ Conference is the confusion of one man multiplied by the number present” TOI
Positive findings on CUE – pyuria and positive nitrite test
Pyuria is WBC > 10 cells/microL, and is present in 85% of symptomatic children.
Pyuria is NOT SPECIFIC for UTI
Positive nitrite test – 50% of cases
Urine for general exam in NOT adequate for diagnosis
UTI: Diagnosis Method of collection Quantitative culture- UTI present Suprapubic aspiration Growth of urinary pathogens in any number Catheterization in females or midstream void in circumcised males Febrile infants or children usually have >/= 50 x 10 3 CFU/mL of a single urinary pathogen Midstream clean void Symptomatic patients: usually >/= 10 5 CFU/mL of a single urinary tract pathogen Bag specimen Useful only if the culture is negative
“ Sorely neglected in most recommended protocols for evaluating urinary infection is an investigation for micturition disturbances which may be responsible for the infections.Treatment of these conditions may actually prevent recurrence of infection. Controversy surrounding the proper imaging evaluation for UTI appears to be misdirected. Instead of arguing about which imaging study should be performed or which child with a first UTI should have a cystogram, our patients might be better served it we wondered why traditional protocols for evaluating UTI deal only with imaging studies.”