Common

Renal & Urinary System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This 3 year and 6 month old girl has presented with fever, abdominal pain and dysuria, a triad of symptoms suggestive of a urinary tract infection (UTI). This diagnosis is supported by the urinalysis showing increased pus cells, and positive leukocyte esterase and nitrates.\n\nThe fever is mild, she is non-toxic, and not dehydrated or hemodynamically unstable; nor is renal angle tenderness present, while a full blood count is also within normal parameters. Thus, there appears to be no immediate emergency.\n\nThe first step in her management should be initiation of empirical antibiotic therapy; however, urine should be sent for culture and antibiotic sensitivity testing beforehand.\n\nNote that co-trimoxazole is a good first-line agent in this regard, due to minimal reported drug resistance; ciprofloxacin is best avoided in children, due to safety concerns.\n\nAn analgesic such as acetaminophen should also be administered for symptomatic relief.\n\nThe next step is to decide on whether imaging of"}]}

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