Aarav was 3 months old when he was brought in with nonstop crying and low-grade fever. His mother had been to two ERs, each time told it was colic. But colic doesn’t cause a fever. When I examined him, his abdomen was mildly tender. No cough, no rash, no ear infection.

We ran labs, including a urine culture via catheter. It revealed a significant E. coli infection. He had a urinary tract infection, which led to mild pyelonephritis. After IV antibiotics and follow-up renal ultrasound, he recovered completely.

The mother hugged me, weeping—not out of relief alone, but out of exhaustion from not being believed.

The Lesson Learned

In infants, a fever without source is a red flag—always consider a UTI. Colic is a diagnosis of exclusion, not assumption.

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