A 2-year-old presents with fever, vomiting, poor appetite, and foul-smelling urine. Which additional findings support a likely diagnosis of a urinary tract infection?

A. Hepatomegaly: Liver enlargement is not associated with urinary tract infections. It is more commonly linked to metabolic disorders, cardiac issues, or liver disease, making it unrelated to this child’s presentation. B. Straining or crying with urination: Painful urination is a hallmark of UTI in young children. Irritability, crying, or straining while voiding indicates bladder or urethral irritation from infection. C. Persistent diaper rash: Diaper rash is typically due to skin irritation from moisture or yeast overgrowth. While common in infants and toddlers, it does not specifically indicate urinary tract infection. D. Cloudy urine with foul odor: Cloudy, malodorous urine suggests bacterial overgrowth and pyuria. This is a classic finding that supports a UTI diagnosis, especially with fever and vomiting. E. Frequent urination: Increased urinary frequency results from bladder mucosa irritation caused by infection. It is a typical symptom in pediatric UTI and adds further evidence to the diagnosis.