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Bronchiolitis- Is source enough?

Anand Swaminathan, MD FAAEM and Mel Herbert, MD MBBS FAAEM
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Paul B., M.D. -

Concominant UTI in bronchiolitis was 3%. Are there any studies on the rate of asymptomatic UTI/bactiuria in normal children. It would be interesting to know because if these children have a febrile illness from bronchiolitis but incidentally have bacteria in their urine is it truly significant. Should we be screening every child that walks through our EDs for UTI? I remember a few years ago studies that showed that febrile patients with otitis also had incidental UTI's. Ive always wondered that...

Anand S., M.D. -

Interesting point. I've also seen a study on meningitis where about 3-4% were said to have concomitant UTI. I agree that it doesn't make a lot of sense. Seems likely that 3-5% of kids have bactiurria at baseline and not an actual infection. I think the issue here is that if you find it, you have to treat it because these kids don't have symptoms because of their age and the only reason the urine was done was because of fever.

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Episode 138 Full episode audio for MD edition 246:41 min - 103 MB - M4AResumen Marzo 2013 en español Español 72:06 min - 25 MB - MP3EM:RAP 2013 March MP3 80 MB - ZIPEM:RAP March 2013 Written Summmary 2 MB - PDFNew Feature: EM:RAP March 2013 Board Review Questions 1 MB - PDFNew Feature: EM:RAP March 2013 Board Review Questions: Answer Sheet 654 KB - PDF

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