To think dr was wrong?

[lucie333]

My son who is 3.5 came home from nursery with a temp, crying in pain whenever he tried to pee, he was ago sick when he got home had a temp of 39.5 & very lethargic- never seen him to unwell actually. I took him to dr who requested we did a urine sample- I tried my best but he was crying in too much pain he just couldn't do it, he then examined him and his boy parts seemed okay, no signs of infection or anything like that. He told me to go him and give him regular calpol, I said I wasn't happy to get sent home with nothing as I'm positive he has urine infection but he said it's too early to tell, he also said he can't prescribe without pee sample and I asked if it was possible to get sent to hospital for them to do one and he said it wasn't necessary, I trusted his word and left... I'm now thinking that possibly wasn't the right thing to do. I tried my best to get him to pee for me when we got home but he was crying saying please no mummy😢 he eventually let one out when he was in the bath ( yuck I know but it seemed more comfortable for him)

I guess my question is, was the dr right with not prescribing antibiotics?

i would think sepsis is a different kettle of fish and their acting fast.

I think PP meant more routine pee samples where the parents haven’t been able to collect one yet.

GP here. I am so sorry your child is so poorly and know how worrying it is- but this is a circumstance where waiting for a few hours to get a sample is really worth it. UTIs are very rare in boys and need further investigations. The investigations are not pleasant and we do not want to do them
if there is no need. To do the investigations you need confirmation of whether there was a UTI or not- not just prescribing antibiotics
over the phone. The doctor is correct and the 111 nurse wrong.

What happens now if your child doesn’t get better despite the antibiotics? We still have no diagnosis and we still don’t know whether this is just a virus or whether it was a UTI but that has been treated with incorrect antibiotics. There is reasoning behind the doctors’ actions- I totally understand that it doesn’t seem so but if possible please try and get a sample before starting them.

I hope the antibiotics help, OP.

We needed to get a urine sample once from my DS when he was a bit younger than yours and not quite toilet trained.
The GP surgery gave me a pack of something that I think was called the Newcastle Urine Collection kit - it was basically some urine collection pads that went inside his nappy, I had to wait for DS to wee into them and then use a syringe to suck wee out of the pads and get it into a sample bottle.

If he has a nappy at night, pop some cotton wool balls in it, they soak up the moisture then can be squeezed into the sample pot

Sorry OP, this is true.

Catheterisation on a toddler to get a urine sample is just crazy. Also, more likely to introduce an infection and trauma.

@ChairFloorWall completely agree, what I meant was that I find it strange that a paeds A&E nurse never once came across that situation in her 20 year career.

I find this odd - my son (who is almost 17) has had urine infection symptoms and dr has prescribed meds to start while waiting for sample to be tested as it takes three days. Hurting while he pees is a huge red flag I would ring 111 and say concerned with drs advice.

Hey I have just noticed now the posts about sepsis, my apologies!
He seems to be better this morning playing with his brother, can kids of have sepsis get better or do they get progressively worse?

All kids are different but they usually get worse. Did you get antibiotics?

Start him on a home remedy it might clear up without prescription

https://www.healthline.com/health/uti-home-remedies#hydration

Ask him, in tandem, to pee in a jug so you can collect a sample. Once you have a sample run it round to gps and ask for a test by a nurse. Normally the strip tests are quick to spot proteins so antibiotics can be prescribed.

Hope this helps.

UTIs are horrible. I'm susceptible to them but but following the natural remedy I find I can clear them myself.

We have 3 under 3s and one of our twins had this problem but Dr sent us to a&e. Yes we were there all day and eventually our little one did pee for them and they did find a uti.Sadly she's had another 3 since that first one so we have to do same procedure every time. They also gave her better pain relief aswell. Being an adult who also gets them often the pain is horrendous so get your wee one to a&e to get sorted as the Dr doesn't have the time to wait for a sample like they do.Hope he is better soon bless him it's an awful pain if it is a uti.

It's not strange at all

For future reference, for all those saying collect the wee in a 'clean' jug, put cotton wool balls in nappy etc - these are not ok when looking for UTI, the collection method must be sterile or normal surface bugs will be collected and multiply, making the sample uninterpretable.
That's why paeds departments have little children perched over little sterile bowls waiting for the precious golden drops!

I don’t know enough about it as I am not a doctor but the vomiting, fever, and not passing urine for so long would be enough of a reason for me to be up at A&E. I know someone whose child died of sepsis. There is a campaign at our local hospital that encourages parents to ask, “Could it be sepsis?”

At the very least raise it with the GP.

update

Managed to get a urine sample, he's telling me he still doesn't feel well, he's still got a temp, he has had 2x doses of antibiotics & calpol. He's sleeping just now, 1 million things running through my head right now. Should I take him to dr again?

@confusedlots suspected sepsis and op who just wanted a urine sample are not the same thing

I'd just monitor him, if you can still wake him and he's smiling from time to time, playing a bit then then give it more time. If he becomes drowsy, really miserable etc then take him back. You can give ibuprofen too so try that and drop the urine off. Hope this helps.

Not necessarily without intervention . I have a male family member who couldn't pee literally went days and was in so much pain and discomfort he was taken to hospital by ambulance and had to have a catheter fitted to empty his bladder. A&e doc couldnt believe hiw much his bladder was holding. turned out to be a severe water infection

I was told by our GP it's standard practice to prescribe antibiotics immediately with boys /men who have symptoms of a UTI.

This isn’t relevant to OP or boys; but a GP spent a year, prescribing antibiotics to FIL for UTIs, without testing his urine for bacteria - in fact he had bladder cancer!

The opposite is true - they're uncommon in males because of the longer urethra.

The doctors / nurses can give you a little sticky bag to collect the sample.. it goes over his bits. Obvs for kids in nappies but it might help than you physically collecting it

I would, and I'd ask about appendicitis. My kiddo also didn't want to wee.

kangaroopelicanartic · Today 19:19
Makingupfactstosuitmyagenda · Today 01:18

I recall sitting holding a sample bottle trying to catch ‘the moment’
with my 4 month old. Apparently they needed a ‘clean’ sample to culture. He was in hospital at the time and iirc antibiotics were started before the results came back as the sample
ended up being lost anyway. I was told at the time that urine infections are common in little boys as the urethra is short. Not sure if this is true.
The opposite is true - they're uncommon in males because of the longer urethra.

the comparison wasn’t gender, it was age ie ‘little boy’ and older male.

Don't worry about having a temperature, this is a normal response to infection and a good sign that his immune system is working. It's not something you need to worry about or try to eliminate with paracetamol. By all means paracetamol if grouchy/uncomfortable but not just for fever.

From what you describe it sounds like the GP had a sound plan in regards to awaiting the urine sample to be dropped in tomorrow, it could have been tested and may have helped a more informed diagnosis. GPs really are specialists at this type of medicine/planning.

In regards to what to do now, I would make sure he's drinking more fluids than normal, if persists in having really poor urine flow I would consider either returning to GP, or if not passing at all over 12 hours then A&E. If he begins to look very unwell to your eye - floppy, difficult to engage, not drinking, breathing seems quick or struggling then just goto A&E - you don't need permission from 111 you can just go.

Regards the urine sample, I would drop it in tomorrow if that's what the GP had requested/suggested. But just provide a note that you spoke with 111 and they started him on the antibiotic already, presumably trimethoprim?

@lucie333 How did things work out today, did you get the sample handed in to confirm UTI or was it something else?

Interested as my Ds has similar on and off. Urine is always clear.