DefinePK

Abstract

Background: Urinary tract infection (UTI) is one of the most frequent bacterial causes of fever in children and often remains underdiagnosed due to its nonspecific presentation. Early recognition is critical, as delayed diagnosis can lead to complications such as renal scarring, hypertension, or sepsis. Identifying the frequency of UTI among febrile children, especially those without localized symptoms, is essential to enhance clinical vigilance and improve diagnostic accuracy.
Objective: To evaluate the frequency of urinary tract infections in children presenting with fever and identify associated clinical risk factors.
Methods: This cross-sectional study was conducted at the Department of Pediatrics, Hayatabad Medical Complex, Peshawar. A total of 202 children aged 0–5 years presenting with fever >100.4°F (38°C) of less than 7 days’ duration were enrolled using consecutive non-probability sampling. Children with prior UTIs, recent antibiotic use, congenital urinary anomalies, or requiring hospitalization were excluded. Clean-catch midstream or catheterized urine samples were collected under aseptic conditions. Initial screening was performed using dipstick testing for leukocyte esterase and nitrite, followed by confirmation via urine culture, where ≥10⁵ CFU/mL of a single uropathogen was considered diagnostic. Data were analyzed using SPSS version 25, with significance set at p<0.05.
Results: Of the 202 children enrolled, 92 (45.5%) were male and 110 (54.5%) female, with a mean age of 2.91 ± 1.40 years. UTI was confirmed in 29 children (14.4%). Among UTI-positive cases, 19 (65.5%) were aged 1–3 years, and 23 (79.3%) had a fever duration of more than 24 hours. Dysuria was reported in 14 (48.3%) cases, while frequent urination was present in 8 (27.6%).
Conclusion: UTI was identified in a considerable proportion of febrile children, particularly among those with prolonged fever exceeding 24 hours. These findings advocate for routine urine evaluation in febrile pediatric cases lacking a clear source.