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Child having vaginal itching. Positive leucocytes in urine test. Is this an infection? Has ear infection. Need antibiotics for both?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
Hi my 5 year old daughter complained yesterday of itchiness in vaginal area, i checked with a Dipstick her urine and it showed positive leukocytes but everything else has been normal. Her ph is a bit closer to 8. She hasn't complained since last night. No pain or frequency or burning. But I keep rechecking and her leukocytes are at moderate to severe positive. Her pediatrician send it to culture but results in a few days, and we are leaving in a few days to a cruise. My questions what does positive leukocytes mean, could she have an infection without symptoms and would vantin antibiotic be appropriate for uti as for ear infection she has now. We don't want to give her 2 different antibiotic but would like one that works for both problems.
Posted Fri, 6 Jul 2012 in Child Health
Answered by Dr. Hema Yadav 2 hours later
Thanks for posting your query.
Answer 1. Yes positive leucocytes (pus cells) in urine indicate most probably an infection. Itchiness in genitalia can be the only symptom to begin with. Later on fever, pain in abdomen or burning micturition might develop .
Asymptomatic urine infection can occur especially in female child due to short urethra and more susceptibility of contamination of the same.
Answer 2 Vantin or cefpodoxime is mostly used for respiratory tract infections however it canbe used in minor uncomplicated UTI .The usual pediatric dose is 5mg/kg/dose every 12 hourly.
However it's best to get the culture done to confirm the diagnosis before starting the antibiotic . So kindly discuss it with your pediatrician .
Meanwhile make sure you hydrate your child with plenty of water for faster recovery.
As of now if you have already started the antibiotic then you may complete the course as per your doctors advice and then go for a culture test to ensure resolution of the UTI .
Hope I have answered your query.
Wishing your child a speedy recovery.
Above answer was peer-reviewed by
Follow-up: Child having vaginal itching. Positive leucocytes in urine test. Is this an infection? Has ear infection. Need antibiotics for both? 31 minutes later
My Question which antibiotic is best used for uti in children? Is macrobid another option? Her nitrates are negative does it mean it may not be infection?
Answered by Dr. Hema Yadav 1 hour later
Thanks for posting your query.
Answer 1. The most preferred antibiotic for UTI in children are broad spectrum antibiotics like betalactams ( penicillin , cephalosporin ) , trimethoprim sulphamethoxazole( septran) or quinolones( norfloxacin Though less preferred due to sideffects ). Ideally ,The best choice is what the antibiotic sensitivity report of urine culture suggests and what the local prevalence studies suggest.

Answer 2.Macrobid is indicated only for the treatment of acute uncomplicated cystitis) caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus. It's not a broad spectrum antibiotic and might not be the best choice for treating both UTI and otitis (ear).

Answer 3. A nitrite test is a standard component of a urinary test strip. A positive test for nitrites in the urine is called nitrituria.

This test is commonly used in diagnosing urinary tract infections. A positive nitrite test indicates that the cause of the UTI is a gram negative organism, most commonly Escherichia coli. The reason for nitrites existence in the presence of a UTI is due to a bacterial conversion of endogenous nitrates to nitrites .
False negative nitrite tests in urinary tract infections occur in cases with a low colony forming unit count, or in recently voided or dilute urine. In addition, a nitrite test does not detect organisms unable to reduce nitrate to nitrite, such as enterococci, staphylococci, or adenovirus.
So its best to get a conventional urine routine and culture test for reliable diagnosis .
Hope that answers your queries.
Kindly accept my answer if you have no further queries.
Wishing your child a speedy recovery and good health.
Above answer was peer-reviewed by
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