This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shaw, K. N.
Right arrow Articles by Schwartz, J. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Shaw, K. N.
Right arrow Articles by Schwartz, J. S.
Related Collections
Right arrow Emergency Medicine

PEDIATRICS Vol. 102 No. 2 August 1998, p. e16

ELECTRONIC ARTICLE:
Prevalence of Urinary Tract Infection in Febrile Young Children in the Emergency Department

Received Feb 2, 1998; accepted Apr 17, 1998.

Kathy N. Shaw*, Marc Gorelick*, Karin L. McGowan*, Noreen McDaniel YakscoeDagger , and J. Sanford Schwartz§

From the * Departments of Pediatrics and Dagger  Nursing, Children's Hospital of Philadelphia, and § the Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania.

Objective.  Establish prevalence rates of urinary tract infection (UTI) in febrile infants and young girls in an emergency department (ED) by demographics and clinical parameters.

Methods.  Cross-sectional prevalence survey of 2411 (83%) of all infants younger than 12 months and girls younger than 2 years of age presenting to the ED with a fever (>= 38.5°C) who did not have a definite source for their fever and who were not on antibiotics or immunosuppressed. Otitis media, gastroenteritis, and upper respiratory infection were considered potential but not definite sources of fever.

Results.  Overall prevalence of UTI (growth of >= 104 CFU/mL of a urinary tract pathogen) was 3.3% (95% confidence interval [CI]: 2.6,4.0). Higher prevalences occurred in whites (10.7%; 95% CI: 7.1,14.3), girls (4.3%; 95% CI: 3.3,5.3), uncircumcised boys (8.0%; 95% CI: 1.9,14.1), and those who did not have another potential source for their fever (5.9%; 95% CI: 3.8,8.0), had a history of UTI (9.3%; 95% CI: 3.0,20.3), malodorous urine or hematuria (8.6%; 95% CI: 2.8,19.0), appeared "ill" (5.7%; 95% CI: 4.0,7.4), had abdominal or suprapubic tenderness on examination (13.2%; 95% CI: 3.7,30.7), or had fever >= 39°C (3.9%; 95% CI: 3.0,4.8). White girls had a 16.1% (95% CI: 10.6,21.6) prevalence of UTI.

Conclusions.  UTI is prevalent in young children, particularly white girls, without a definite source of fever. Specific clinical signs and symptoms of UTI are uncommon, and the presence of another potential source of fever such as upper respiratory infection or otitis media is not reliable in excluding UTI.

Key words: UTI, evaluation of febrile infants, prevalence.




This article has been cited by other articles:


Home page
JAMAHome page
N. Shaikh, N. E. Morone, J. Lopez, J. Chianese, S. Sangvai, F. D'Amico, A. Hoberman, and E. R. Wald
Does This Child Have a Urinary Tract Infection?
JAMA, December 26, 2007; 298(24): 2895 - 2904.
[Abstract] [Full Text] [PDF]


Home page
AAP Grand RoundsHome page
R. I. Paul and B. M. Pate
Bag versus Catheter Urine Specimens in the Diagnosis of UTI in Young Children
AAP Grand Rounds, April 1, 2006; 15(4): 40 - 41.
[Full Text] [PDF]


Home page
Clin. Microbiol. Rev.Home page
J. J. Zorc, D. A. Kiddoo, and K. N. Shaw
Diagnosis and Management of Pediatric Urinary Tract Infections
Clin. Microbiol. Rev., April 1, 2005; 18(2): 417 - 422.
[Abstract] [Full Text] [PDF]


Home page
Med Decis MakingHome page
R. S. Van Howe
A Cost-Utility Analysis of Neonatal Circumcision
Med Decis Making, November 1, 2004; 24(6): 584 - 601.
[Abstract] [PDF]


Home page
Arch. Dis. Child.Home page
J H van der Voort, A G Edwards, R Roberts, R G Newcombe, and K V. Jones
Unexplained extra visits to general practitioners before the diagnosis of first urinary tract infection: a case-control study
Arch. Dis. Child., December 1, 2002; 87(6): 530 - 532.
[Abstract] [Full Text] [PDF]


Home page
Evid. Based Nurs.Home page
G. E. Harkless
A clear urine specimen on visual inspection cannot totally exclude a diagnosis of urinary tract infection
Evid. Based Nurs., April 1, 2001; 4(2): 55 - 55.
[Full Text]