Can Fam Physician. 2024 Mar;70(3):169-170. doi: 10.46747/cfp.7003169.
An 8-month-old boy presented to our clinic with a 3-day history of fever. He has had a cough and rhinorrhea since the onset of the fever, and his 4-year-old sibling has recently had cough and cold symptoms. I have heard that the presence of respiratory symptoms means that urinary tract infection (UTI) is less likely. In infants with fever and respiratory symptoms, who should have a sample collected for urinalysis for UTI?
The approach to diagnosing febrile infants who have respiratory symptoms varies by age. Urinalysis should be done for all febrile infants younger than 2 months of age, regardless of whether they have respiratory symptoms. Clinicians should assess risk factors for UTI in every infant between 2 and 24 months of age and should not exclude the diagnosis of UTI based on respiratory symptoms alone. Use of a predictive tool to estimate the pretest probability of UTI would aid decision making about patients in this population.
一名 8 月龄男婴因发热 3 天就诊。他自发热开始就有咳嗽和流涕，其 4 岁的兄弟姐妹最近有咳嗽和感冒症状。我听说有呼吸道症状意味着不太可能是尿路感染（UTI）。对于有发热和呼吸道症状的婴儿，谁应该采集尿液样本进行 UTI 尿检？
诊断有呼吸道症状的发热婴儿的方法因年龄而异。所有小于 2 个月龄的发热婴儿都应进行尿检，无论其是否有呼吸道症状。对于 2 至 24 个月龄的婴儿，临床医生应评估 UTI 的危险因素，不能仅凭呼吸道症状就排除 UTI 的诊断。使用预测工具来估计 UTI 的术前概率有助于决策有此人群的患者。
