Urinary tract infection (pediatrics) Quiz: Ace Your Exams

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A 6-month-old girl is brought to the emergency department for evaluation of irritability and foul-smelling dark urine for two days. The patient’s parent reports that the patient has been tolerating oral intake without vomiting. The patient has no chronic medical conditions and has never taken antibiotics. Temperature is 38°C (100.4°F), pulse is 167/min, respiratory rate is 40/min, blood pressure is 90/50 mmHg, and oxygen saturation is 99% on room air. On physical examination, the patient is crying but is consolable. Mucous membranes appear moist. Abdominal exam is normal. Cardiopulmonary and HEENT examinations are within normal limits. Genitourinary examination shows normal appearing female genitalia. A straight catheterization is performed with results shown below. Which of the following is the most appropriate antibiotic to initiate at this time?  

Laboratory value
Result
Reference
Urinalysis


Color
Clear
Clear
Specific gravity
1.013
1.002 - 1.030
Glucose
Negative
Negative
Blood
Negative
Negative
Leukocyte esterase  
Large
Negative
Nitrites
Positive
Negative
Leukocytes
50-100/hpf
2-5/hpf
Erythrocytes
1-2/hpf
<4/hpf
Dysmorphic RBCs  
Absent
Absent
Casts
None
None

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