How to calculate probability of UTI in febrile infants

Urinary tract infection (UTI) in pre-verbal infants is not only one of the most common bacterial infections we see, but also the most difficult to diagnose. The younger the infant, the more it matters and the more difficult it is. How can we pick out the few with a potentially kidney-damaging UTI from the mass that present with fever and no focus? The Holy Grail would be a simple instant test that could distinguish harmful bacteriuria with 100% specificity and sensitivity, so that no UTIs are missed, and unnecessary invasive urine collection and antibiotic prescription is avoided. No such test exists as yet, so it seems worth trying to do better with what we have.

Researchers from Pittsburgh, USA, analysed a database of 384 infants aged 2 to 23 months who had presented to their emergency department with a fever of 38°C or more, between 2007 and 2013 (Shaikh N et...

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