A five year old male child presents with complaints off ever and abdominal distension He is having vomiting for the last five days. On examination there are 6-8 Pus Cell/hpf in urine. WBC count shows 78% neutrophils. What is the best line of management -(AIIMS Nov 2012)
|A||Send urine for culture and sensitivity and wait for results|
|B||Send urine for culture and sensitivity and start I.V. antibiotics immediately|
|C||Send urine for culture do an USG and start chloroquine|
|D||Radio nucleotide studies|
Send urine for culture and sensitivity and start I.V. antibiotics immediately
Clinical manifestations of UTI
Three basic forms of UTI are -
o Abdominal pain or flank pain o Nausea and vomiting o Malaise
o Fever o Abdominal distension
o Dysuria o Frequency o Incontinence
o Urgency o Suprapubic pain o Malodorous urine
c. Asymptomatic bscteriuria
o Positive urine culture without any symptoms.
Coming back to question -
a. Fever, vomiting, abdominal distension with 6-8 pus cells/hPfin urine suggest the diagnosis of UTI, more specifically pyelonephritis.
b. The investigation which almost confirms the diagnosis of U.T.I is presence of 6-8 puscells / high power field.
c. "The presence of pyuria (>5 white blood cells/ high power field) is consistent with urinary tract infection."
d. Once U,T.I. is suspected, urine specimen is sent for culture and treatment started:
Don't wait for results of the culture.