In anticipation of EM Cases Episode 123 Pediatric UTI Myths and Misconceptions, Dr. Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric UTI can lead to over-testing, over-treating and even worse outcomes. In the upcoming main episode podcast we will discuss risk stratification, who to test, how to test, urinalysis interpretation, indications for blood tests, antibiotics of choice, which children require imaging and much more…

Podcast production, editing and sound design, blog post by Anton Helman, April 2019

UTI Calc

For children 2-23 months of age

Step 1

Probability of UTI based on clinical characteristics

Age < 12 months

Maximum temperature ≥ 39 C (102.2 F)

Self described race as black

Female or uncircumcised male

Other fever source

Step 2

Probability of UTI based on clinical and lab characteristics

Nitrite present

Leukocyte esterase – none, trace, 1+, 2+ or 3+

WBC/mm3

Bacteria on Gram stain