Search for a command to run...
Introduction. Urinary tract infections (UTIs) are among the most common bacterial infections in children and may signal underlying structural or functional abnormalities, particularly in febrile cases. Escherichia coli is the leading pathogen, and prompt diagnosis with appropriate treatment is essential to prevent complications such as renal scarring. Case presentation. We report a 5-month-old baby girl, admitted with high-grade fever, vomiting, irritability, and diarrhea. Laboratory tests revealed leukocytosis, elevated inflammatory markers, significant pyuria, nitrite positivity, and proteinuria. Presepsin level (1903 pg/mL) confirmed systemic bacterial infection. Empirical intravenous cefuroxime was initiated and later escalated to cefotaxime due to clinical deterioration. Supportive measures included intravenous fluids, antipyretics, and probiotics. Abdominal ultrasound showed bilateral renal involvement consistent with acute pyelonephritis, preserved corticomedullary differentiation, and no post-void residual. The patient improved gradually, with normalization of inflammatory markers, and was discharged after 9 days with recommendations for oral antibiotics, dietary adjustments, and pediatric nephrology follow-up. Conclusion. This case highlights the importance of early recognition, biomarker use, and targeted antimicrobial therapy in pediatric UTIs. Addressing comorbidities, such as cow’s milk protein allergy, may reduce recurrence risk. A multidisciplinary approach, combined with careful monitoring and preventive strategies, is essential to optimize outcomes and prevent long-term renal damage.