Paediatric urinary tract infection — MCCQE Part 1 MCQ

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ModerateDysuriaPaediatric urinary tract infectionMCCQE Part 1

A 3-year-old girl has fever, dysuria, and abdominal pain. Urinalysis from a clean-catch sample shows leukocyte esterase and nitrites; she is not vomiting and appears well. What is the most likely diagnosis?

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Correct answer: A — Urinary tract infection

Fever and dysuria with nitrites and leukocyte esterase on urinalysis in a toilet-trained child strongly suggest UTI. Vulvovaginitis may cause irritation but usually lacks nitrite-positive urine and fever. Appendicitis would not explain the urinary dipstick pattern as well. Nephrotic syndrome presents with oedema and proteinuria rather than dysuria.

Reference: CPS urinary tract infection guidance