“Malodorous” Urine Isn’t Necessarily a UTI

Which is to say, when a parent brings in a child with a fever and the urine “smells bad”, plenty of those kids have normal urine cultures and plenty of children with Febreeze for urine have a urinary tract infection, regardless.


This is a prospective cohort study enrolling children receiving a urine culture as part of an evaluation for fever without a source in the Emergency Department – and then they went back and data mined for associations between the group diagnosed with UTI and not.  The overall incidence of UTI was 15%.  The overall incidence of UTI in those with “malodorous” urine was 24%.  It was the most significant contributing factor they found, but it’s still not sensitive or specific enough to use in isolation to change management.


Other interesting tidbits:  no circumcised male had a UTI, known high-grade vesicoureteral reflux predicted UTI.


“Association of Malodorous Urine With Urinary Tract Infection in Children Aged 1 to 36 Months”
http://www.ncbi.nlm.nih.gov/pubmed/22473364