← All decks
The first 25 slides, exactly as they appear. The full deck has 59 content slides.
Paediatric Surgery
Evaluation and Management of Urinary Tract Infections in C
Built from Puri — Pediatric Surgery and Pediatric Urology
What’s inside
10 sections · 59 slides
Overview
- What this deck will teach you
Why the whole approach has changed
From investigate-everyone to test-only-when-it-matters
- What a UTI is, in plain terms
- Why UTIs matter - and why not to over-worry
- The danger of over-diagnosis
- The pendulum has swung
Epidemiology
How common, in whom, and the reconsidered kidney-failure risk
- The size of the problem
- Who is at highest baseline risk
- Circumcision - the numbers behind the debate
- Rethinking the kidney-failure risk
Etiology
Which organisms, and how they actually cause infection
- Where the bugs come from
- How uropathogenic E. coli (UPEC) invades
- More UPEC weapons - and climbing to the kidney
- Beyond E. coli: other organisms
Presentation
How a UTI shows itself changes with age
- What shapes the presentation
- NICE definitions - naming the level of infection
- Asymptomatic bacteriuria - do not chase it
- Symptoms by developmental stage
- What else could it be? (differential diagnosis)
Diagnosis
Prove the infection before you act on it
- Why confirmation is non-negotiable
- What actually confirms a UTI (AAP)
- Collecting the urine - from clean to invasive
- AAP testing strategy - matched to how sick
- NICE testing strategy
- Guidelines side by side: urine collection
Imaging
Which pictures, in whom, and the great bottom-up vs top-down debate
- The imaging toolkit
- Ultrasound (RBUS) - the safe first look
- AAP imaging recommendations
- NICE imaging - it depends on age and how atypical
- DMSA scan - the scarring reference test
- Blood markers - can they flag kidney involvement?
- Reflux into both kidneys on a bladder dye study
- Vesicoureteral reflux (VUR) and the VCUG
- When guidelines actually order a VCUG
- Two strategies to hunt for reflux
Management
Treat the infection, and rethink long-term prophylaxis
- Acute treatment - keep it proportionate
- When to give antibiotics by vein
- Antibiotic prophylaxis - the big controversy
- What the reflux trials actually showed
- Circumcision and surgical management
- Surgical conditions that predispose to febrile UTI
Bladder and Bowel Dysfunction
A treatable driver of recurrent infection
- What bladder and bowel dysfunction (BBD) is
- Evaluating a child for BBD
- Treating BBD - fix the plumbing habits first
Conclusions
Balance the risks; follow the evidence
- Key takeaways
- Why has routine VCUG fallen out of favour after a first febrile UTI?
- References (1/3)
- References (2/3)
- References (3/3)
- Pediatric Surgery and Pediatric Urology