I would have admitted since the kid relies on the solitary kidney for renal function. It almost doesn’t matter that the kid looks good with that particular background Pmhx
My two cents...
Sent from my iPhone
> On Feb 5, 2018, at 9:56 AM, Kevin Schreiber <[log in to unmask]> wrote:
> Hello all,
> It seems like we can never get away from this issue.
> I am a Peds EM doc who also works in a peds practice.
> Recently saw a vaccinated 2.5 month old baby girl with a known history of a
> solitary kidney and possible bladder diverticulum who presented to me with
> a URI symptoms and a tactile temp. Happy, Interactive, no vomiting.
> In clinic had a temp of 38.7. Exam unremarkable except for mild
> rhinorrhea. Received TylenoI. I explained to the family that I felt there
> should go to the ER and if there was a suspicion for a UTI, they would need
> admission for IV antibiotics.
> In the ED, had a CBC, Electrolytes, Blood Culture, UA, UCX and CRP
> CBC WBC=9.8, no left shift, BUN CREAT normal, Glucose 101, Crp 0.26
> UA (suprabic) Leuk esterase 3+, Nitrite +
> The baby was sent home with oral antibiotics, to follow up as an outpatient.
> I was perplex and confused with the decision for no IV antibiotics,
> especially with the solitary kidney history, Would a normal CBC / CRP sway
> your thought process?
> Comments? Thoughts?
> Kevin Schreiber
> PEM Attending
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