How do you differentiate between asymptomatic bacteruria and a true urinary tract infection in pediatric patients with urinary diversions who have a positive urine culture?

This is a very good question without a perfect answer. Much research is ongoing to better understand this exact question. Currently, the best answer I can give is to rely on symptoms and the degree of pyuria. Pyuria suggests inflammation, so in the absence of pyuria, a positive culture is more likel...