Introduction: Urinary tract infections (UTIs) pose a significant diagnostic challenge in febrile children, with potential for severe long-term complications if untreated. The aim of the study was to determine the prevalence of UTIs in febrile children.

Material and Methods: A cross-sectional study was conducted at Mediciti Institute Medical Sciences, involving 500 febrile children aged less than five years. Data on demographics, clinical presentation, and urinary tract abnormalities were collected. Urine samples were cultured and causative organisms identified.

Results: UTIs were diagnosed in 20% of infants (0-12 months), 13.6% of toddlers (13-36 months), and 12.5% of preschoolers (37-60 months). Female children showed a higher UTI prevalence (20%) compared to males (12%). Dysuria and urinary frequency were strongly associated with UTI diagnosis. 60% of children with urinary tract abnormalities were UTI positive. E. coli was the predominant causative organism, responsible for 62.5% of UTIs.

Conclusion: Febrile infants, especially females and those with urinary tract abnormalities are at a heightened risk for UTIs. The findings underscore the need for timely diagnosis and treatment to prevent potential complications. E. coli remains the leading uropathogen, guiding empirical antibiotic therapy.