Pretest possibility of UTI in kids <2 yo
- Female ~7% in <1 yo, ~2% in >1 yo
- Male ~6% if uncircumcised, ~1% if circumsized
- However, should remember that this data is from foreign studies. Should adjust according to local settings.
– General rule is female has higher risk than male.
– Male has higher risk if uncircumcised or <6 months.
The best symptoms for UTI in kids <2 yo are
- Fever > 1 day (LR 3.2-3.3)
- Suprapubic tenderness (LR 4.4)
- History of previous UTI (LR 2.3-2.9)
- Using a combination of findings is better than using isolated findings.
Risk of UTI in kids >2 yo (i.e verbal)
- Female~7-8%, male <1%
The best symptoms for these kids are
- Abdominal pain (LR 6.3)
- Back pain (LR 3.6)
- New onset urinary incontinence (LR 5)
- Typical symptoms like dysuria and frequency have LR ❤
- <2 yo: watch out for febrile suprapubic tenderness + history of previous UTI should also make you consider the presence of UTI. Not circumcised puts the child at higher risk.
- >2 yo: symptoms of typical UTI are not that reliable. If they are absent, watch out for abdominal pain/back pain + new onset of urinary incontinence.
Nader Shaikh; Natalia E. Morone; John Lopez; et al. Does This Child Have a Urinary Tract Infection? JAMA. 2007;298(24):2895-2904