What is the role of urinalysis in the workup of pediatric urinary tract infection (UTI)?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Urinalysis alone is not sufficient for diagnosing UTI. Children with unexplained fever or voiding symptoms may have positive urinary cultures even when abnormal findings are not evident on dipstick testing and complete urinalysis. [19, 20, 21, 22, 23, 24, 25] However, urinalysis can help in identifying febrile children who should receive antibacterial treatment while culture results from a properly collected urine specimen are pending. [26]

A study by Lunn et al supports the use of automated microscopy for screening urine samples for culture in children. [27] In 280 urine samples collected from 263 pediatric patients, automated microscopy performed comparably to urine dipstick testing in the diagnosis of UTI; automated microscopy had better specificity and likelihood ratios than dipstick testing, but it had slightly lower sensitivity.


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