Common

A 3 year and 6 month old girl presents with mild fever and diffuse abdominal pain for 1 day, in association with 2 episodes of vomiting. She now complains of dysuria as well.

She was completely healthy earlier, with unremarkable medical and surgical histories. Her developmental milestones are age appropriate. All immunizations are up to date.

Select Relevant Investigations
Complete Blood Count

Performed

WBC: 10,600/mm3 (5,500-15,500)
N: 50% L: 40% M: 6% E: 2%
Hb: 12.3 g/dL (11.5-13.5)
Hct: 38% (34-40)
Plt: 277,000/mm3 (150,000-450,000)
Urinalysis + Urine Culture

Performed

Color: yellow
RBCs: nil
Leukocytes: 20-30/hpf
Casts: none
Protein: normal
Glucose: normal
Organisms: +
Leucocyte esterase: positive
Nitrates: positive
A clean catch sample of urine was sent for culture; results will be available in 18 hours.
Renal Ultrasound

Performed

The ultrasound scan of the kidneys, ureters and bladder is completely normal.
Voiding Cystourethrography

Performed

The voiding cystourethrogram is scheduled for tomorrow.

Select Relevant Management
Acetaminophen
Co-trimoxazole
Ciprofloxacin
Urology Referral stat