Urinary tract infection in the pediatric patient

Little attention has been focused on the identification of urinary tract in fection (UTI) in young febrile children in the emergency department, despit e recent information that suggests both a high prevalence and significant a ssociated morbidity in this population. Most UTIs that lead to scarring or diminished kidney growth occur in children younger than age 4 years, especi ally babies in the first year of life. Overall, prevalence rates of UTI in febrile infants in the emergency department are approximately 3% to 5%, wit h higher rates for white girls, uncircumcised boys, and those without anoth er potential source for fever. Prevalence and risk factors are given so tha t clinicians may identify those febrile children at particularly high or lo w risk of UTI for selective management. Culturing methods, urine screening tests, and culture interpretation are reviewed and management strategies ba sed on these results are suggested.