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I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

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Thursday, 1 May 2014

Urinary Tract Infections in Children

Up to 7% of girls and 2% of boys will have a symptomatic, culture confirmed urinary tract infection (UTI) by the age of six. The prevalence of UTI in febrile infants is approximately 7%. After a UTI, 10-30% of children have scarring


Clinical Features

Infants and children presenting with an unexplained fever of 38°C or higher, for over 24 hours, should have a urine sample tested. Infants and children with an alternative site of infection should not have a urine sample tested. When infants and children with an alternative site of infection remain unwell, urine testing should be considered after 24 hours at the latest.

How to test
Urgent microscopy and culture <3years old
>3 or no microscopy, dipstick testing may act as a substitute
Obtaining a Sample
Clean catch - less likely to be contaminated
Urine bags - useful to rule out, but not to rule in
Urine collection pads
Cotton wool balls, gauze and sanitary towels should not be used to collect urine in infants and children.

Treatments
Upper urinary tract infection - oral antibiotics (cephalosporin or co-amoxiclav) for 7 - 10  days
Lower urinary tract infections - oral antibiotics for 3 days.

Follow Up








References
http://learning.bmj.com/learning/module-intro/urinary-tract-infection-children-diagnosis-treatment-long-term-management-.html?moduleId=10011035&searchTerm=%E2%80%9CUTI%20children%E2%80%9D&page=1&locale=en_GB

http://www.enlightenme.org/the-learning-zone/node/4310
http://guidance.nice.org.uk/CG54/QuickRefGuide/pdf/English
http://dontforgetthebubbles.com/6-pem-papers-change-practice-6-getting-urine-neonates/
http://bestbets.org/bets/bet.php?id=34
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