Rukayya M., 12

Rukayya is a 12-year-old girl who lives with her parents and eight siblings in three-room clay house. Her father works as a commercial motorcycle rider but does not own the motorcycle, while her mother is a housewife. The family struggles to afford daily meals, and the boys sometimes sleep at friends’ homes due to limited space. They use well water and have no electricity. Rukayya was previously well until she developed painful urination, which gradually worsened. Three days later, she developed intermittent fever that was only temporarily relieved with paracetamol. Her symptoms worsened, prompting her mother to seek medical care. She was diagnosed with a urinary tract infection and malaria and admitted for treatment. After four days of care, she responded well and was discharged in stable condition.

Rukkaya Mohammed, a 12-year-old girl and paternal orphan who is currently out of school, was brought to the hospital by her mother with a seven-day history of painful urination and a three-day history of intermittent fever. Her symptoms had worsened in the 24 hours preceding presentation. Clinical assessment showed that she was ill-looking and pale, with significant suprapubic tenderness. There was no renal angle tenderness or clinically palpable enlargement of the liver or spleen. Investigations included malaria parasite testing, urinalysis, packed cell volume and full blood count. Malaria testing was positive and urinalysis showed positive nitrite, supporting the diagnoses of malaria and urinary tract infection. She was admitted and treated with intravenous ceftriaxone for the urinary tract infection, oral artemisinin-based combination therapy (ACT) for malaria, paracetamol for symptomatic relief and a single dose of albendazole. She was monitored during treatment and responded well, with improvement in her presenting symptoms. After four days of admission, she was clinically stable and was discharged home to continue and complete her prescribed treatment and follow-up care.

The immediate prognosis is good, as Rukayya responded satisfactorily to treatment and was clinically stable at discharge. With completion of treatment, adequate hydration, good personal hygiene, and appropriate follow-up, full recovery from the current episode is expected. However, recurrent urinary tract infections may occur if predisposing factors persist. Good personal hygiene and early medical assessment whenever urinary symptoms or fever recur are therefore recommended. If left untreated the UTI and malaria may worsen, potentially causing kidney complications, severe infection, worsening weakness, and other life-threatening complications.