Step II UTI in Kids

[stookie]

Question: a girl that recently had a UTI, which resolved. A renal U/S was done, and was normal. What should be done next?

VCUG, nothing, or a second U/S

I read that you dont invesitgate a UTI in a girl until she has a second UTI.
What is the right answer?

 

[SOUNDMAN]

how old was she, i think under 5 you do the VCUG?? Males basically any age you do it if I remember correctly

 

[stookie]

I read regardless of age in females, after the second UTI you do it. I'm not sure now...

 

[Scaredshizzles]

I read regardless of age in females, after the second UTI you do it. I'm not sure now...

I've read a couple of sources at least that say what soundman does about girls under 4 with just their first UTI should get VCUG. (I think because they don't have the two major risk factors---they might not be in charge of personal hygeine yet as an older kid (presumably mom knows how to wipe properly), and obviously they should not be sexually active like an older adolescent/woman.)

 

[zedx]

well on emedicine, the article on pediatric UTIs suggests: A voiding cystourethrogram (VCUG) is recommended for all infants and young children with a febrile UTI to rule out vesicoureteral reflux

 

[Marimba82]

A VCUG is indicated:

1. in all males regardless of age, who present with their first UTI

2. in females under the age of 5 who present with their first UTI

3. in children of any age who present with recurrent UTI's

Also, the patient must be afebrile for at least 24 hours before you can do it, otherwise you risk re-introducing the infection into the kidneys when you perform the ureteral reflux test.

 

[docmd2010]

according to world, you do a vcug in any kid with their first uti. in older males that get a UTI, world says do u/s.

confusing, i hate when topics like this are so conflicting, makes it harder to study