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Abstract: This article is about a 1-year-old female child who had recurrent fever for 5 days and had no significant abnormalities in blood and respiratory virus tests at the local hospital. After coming to our hospital, we found redness and swelling in the urethra through physical examination, and after urine tests, we confirmed the diagnosis of urinary tract infection.
Basic information】Female, 1 year old
Disease Type】Pediatric fever, urinary tract infection
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】January 2022
Treatment plan】7 days of continuous oral cefaclor
Treatment Period】Home observation and treatment, 3-day outpatient follow-up, total course of treatment about 7 days
Treatment effect] Body temperature returned to normal, and all symptoms improved significantly.
I. Initial consultation
The child’s parents brought her to the clinic. She had a recurrent fever for 5 days, and her blood tests showed no significant abnormalities. The parents of the child were very anxious. After the consultation, we did a detailed physical examination of the child, the heart and lung auscultation were normal, there was no obvious redness or swelling in the throat, no obvious abnormality in the neurological physical examination, the fontanelle was flat and soft, and we found that the perineum and urethra of the baby were red and swollen when we undid the diaper. The child was diagnosed with a urinary tract infection after further clean urine routine was performed and the urine leukocytes were found to be significantly higher. Before doing the urine test, the parents were repeatedly instructed to collect the urine specimen in a standardized manner, to wash the child thoroughly, and to collect the urine from the middle part of the urine when the child is urinating to keep it and send it for testing at the first time, because if the urine specimen is not collected in a standardized manner, it will easily lead to contamination of the specimen and affect the judgment of the results. The report of the urine test showed a significant increase in urine leukocytes, which led to the diagnosis of urinary tract infection.
Second, the treatment process
For children with urinary tract infections, active anti-infective treatment is usually required, so the child was prescribed oral cefaclor, which was recommended to be taken for 7 consecutive days, and the child was asked to have a clean urine culture done at the same time before taking the antibiotics. At the same time, while on the antibiotic, one has to wait for the results of the urine bacterial culture, and if once a specific bacteria is cultured to be present, the antibiotic is adjusted according to the results of the drug sensitivity test. This child had a negative urine bacterial culture result. After 3 days of oral antibiotics, he was seen again and the urine result was normal, and he was instructed to continue oral treatment to complete the course and consolidate the treatment.
III. Treatment effect
According to the parents’ description, the child’s temperature slowly returned to normal after 2 days of oral cefaclor, and now the child is not crying anymore. We advised the parents that it is important to treat urinary tract infections in small children with a full course of treatment, and suggested to consolidate the use of antibiotics for another 4-5 days to avoid recurrence.
IV. Notes
We are glad that the child’s temperature has returned to normal and the symptoms of discomfort have improved. However, due to the young age of the child, the perineum is more difficult to clean, parents also need to be patient to the child to clean, so as to avoid frequent exposure to the pollution of urine and feces excrement, aggravating the urinary tract infection. In general, you should also pay attention to local cleaning care, after each bowel movement, if possible, try to give the child the first time to rinse, to keep the skin clean and cool, or at least to change the diaper more diligently to avoid too long. This will reduce the incidence of urinary tract infections and avoid fever. During the treatment period, the child also needs to drink more water and eat more fresh fruit and vegetable supplements.
V. Personal insight
This paper informs parents that children of young age are prone to fever, and fever itself is an active response of the body, so first of all, there is no need to panic too much, and the treatment should be given promptly. After taking the treatment, we should carefully observe the condition and calmly analyze the possible causes of the fever in order to treat the symptoms. If the temperature does not go down, it is recommended to go to the hospital in a timely manner. For younger children, it is also necessary to analyze all the causes and improve the relevant tests. In addition to the most common respiratory and digestive tract infections, skin problems, urinary tract problems, or neurological infections should also be considered as causes of fever. It is also important to improve knowledge of related diseases in order to take better precautions.