By Dr. Kathleen Bryant
HPI: A 19 month old AA female presents with fever (Tmax 38.7*C) for 36 hours. Mom reports giving Tylenol/Motrin for fever control. Mom denies N/V/D, change in PO intake or change in UOP. Mom reports mild cough and nasal congestion. Immunizations UTD, no sick contacts.
VS: T: 38.7*C RR 16 HR 110 BP 110/80
Gen: well appearing, sitting in NAD
HEENT: bilateral TMs clear, no middle ear effusion, mild nasal congestion, posterior oropharynx clear, no cervical lymphadenopathy
CV: mild tachycardia, no M/G/R, capillary refill brisk, 2+ peripheral pulses
Resp: CTAB, no W/R/R
Abd: NTND, +BS, soft
GU: normal genitalia, no rashes
No source of infection is identified in this patient.
Do we need to obtain an urinalysis to rule out an UTI? Why do we care about UTIs? What is the significance of missed or delayed treatment of UTIs in this patient population?
Clinical Pearls for ED:
Author: Dr. Kathleen Bryant
1. Roberts, K.B., Revised AAP Guideline on UTI in Febrile Infants and Young Children. Am Fam Physician, 2012. 86(10): p. 940-6.
2. Subcommittee on Urinary Tract Infection, S.C.o.Q.I., Management, and K.B. Roberts, Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics, 2011. 128(3): p. 595-610.
Pediatric EM Blog
Pediatric EM Fellows at CMC/Levine Children's Hospital.
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