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Question:

From Delray Beach, Florida, USA:

We were away last weekend when my daughter complained of pain on urination. We took her to a walk in clinic and the doctor performed a urinalysis (with the paper strip) and said she had a UTI [urinary tract infection]. He gave her Bactrim [an antibiotic frequently used for UTI's].

I didn't think anything of it until we went for a follow up to her pediatrician. He said her urine should have been cultured and is recommending that we have an ultrasound of her kidneys done. The urinalysis done is his office showed that she had trace levels of ketones, which he said was due to inactivity (however, she is an extremely active child). Should I be concerned about diabetes? Should I be checking her ketones, and, if so, how?.

Answer:

  1. It is unacceptable to diagnose UTI purely on the basis of a stick test and after treatment has been commenced it's too late.

  2. Given that, you have missed the chance for a definitive diagnosis, I agree with your paediatrician that a kidney ultrasound scan is sensible. The presence/absence of other symptoms of UTI will lend weight to the decision on whether or not to do any more investigations.

  3. Traces of ketones are very common in children and do not require any action.

KJR

Original posting 29 Jan 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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