Don't count on urinary white cells to diagnose childhood urinary tract infection

EDITOR,—Because pyuria is common in febrile children,1 screening for urinary tract infection in children by detecting increased urinary white cells (with leucocyte esterase strips or standard microscopy) will produce false positive results. Because urinary white cells may disappear rapidly,2 such screening will also produce false negative results. We report on a child with a devastating urinary tract infection who had very few urinary white cells for another reason. An extremely ill 8 month old boy presented after 36 …