Anthony Atala, M.D.
Children' s Hospital, Harvard Medical School
Boston, Massachusetts

A previously healthy 6 week-old girl presented to the emergency room with a 24 hour history of poor appetite and fever to 102° F. The mother denied that the patient had any history of genitourinary symptoms or family history of urologic problems. She did, however, note that until 24 hours prior to presentation, the infant's diapers were always wet.

PMH: None

Medications: None

Physical Examination: Unremarkable except for signs of dehydration.

Urinalysis:

Nitrate positive.
WBC too numberous to count.

Urine Culture: > 100,000 E. Coli

Laboratory: Serum WBC 14,000

The patient was admitted to the hospital for parenteral hydration and placed empirically on intravenous antibiotics. Two days later, urine culture returned positive for growth of > 100,000 E. Coli.

Ultrasound