There are a lot of decision support tools out there when it comes to caring for children in the Emergency Department. Urinary tract infections are exceedingly common in febrile children who have not yet been potty trained. UTI Calculator, from the University of Pittsburgh, allows you to plug in risk factors for febrile UTI in children ages 2 to 23 months and get a probability of a urinary tract infection. The factors include:

• Age < 12 months
• Maximum temperature ≥ 39 °C (i.e., 102.2°F)
• History of UTI
• Female or uncircumcised male
• Other fever source
• Duration of fever ≥ 48 hrs

I find that pulling up this website when discussing getting a catheter-obtained urinalysis and culture is an extremely helpful way to discuss risk and probability with parents. I know that many of you are already familiar with how to use this tool – but I wanted to expand the audience as much as possible because it is wonderful. Click the big button below to go to the site – the direct URL is https://uticalc.pitt.edu.

References / More Reading

Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011 Sep;128(3):595-610. doi: 10.1542/peds.2011-1330. Epub 2011 Aug 28. PMID: 21873693.