What is your diagnosis, how to manage?
2 days old child from small village presented with poor urinary stream, lump in lower abdomen, dehydration, lethargy and fever.
No antenatal investigations/history.
5f feeding tube inserted with little difficulty, this was followed by diuresis.
S. Creatinine: 2.3 mg%
S. Electrolytes: within normal limits.
Total white celks count: 18500, polymorphs: 90%.
Urine routine: 30 to 35 pus cells, culture awaited.
USG: bilateral gross HUN, bladder trabeculated, bladder neck hypertrophied and posterior urethra dilated.
He is put on 3rd generation cephalosporine. Under treatment of pediatrician for dehydration and sepsis.
He responded treatment. VCUG done on 5th day, attached for review.
Please discuss diagnosis and treatment