Peds ID Abx QOTW #12 Answer
d) Call the patient to see how she is doing and discuss with her that this is likely asymptomatic bacteriuria and it does not need treatment
• To diagnose UTI, there should be pyuria and symptoms of UTI such as dysuria, frequency, urgency
– This patient has only vague symptoms of abdominal pain and nausea
• A positive urine culture without pyuria or symptoms of UTI is most likely asymptomatic bacteriuria, which is a common finding in young women, especially those who are sexually active
– Prevalence of asymptomatic bacteriuria ranges from 1% in school-age girls to 5% in university student health center patients
• Since this patient is sexually active, other causes for her symptoms should be sought, including pregnancy and sexually transmitted diseases / pelvic inflammatory disease
• Reference: Hooton TM, NEJM 2000;343(14):992-7