A 30-month-old girl who has been toilet trained for 6 months has daytime enuresis and dysuria and a low-grade fever. A dipstick urinalysis is negative for leukocyte esterase and nitrites. What is the next step?

Question

Quizplus · Accepted Answer

The negative dipstick urinalysis does not rule out a urinary tract infection (UTI) in a young child. The symptoms of dysuria, fever, and daytime enuresis are suggestive of UTI. Therefore, sending the urine to the lab for culture is the next appropriate step in the management of this child. Empiric treatment with antibiotics should not be initiated without confirming the diagnosis of UTI with a urine culture. Behavioral interventions for toilet training would not be helpful in this case.

A 30-Month-Old Girl Who Has Been Toilet Trained for 6