My 3 yr old has painful urination. the urinalysis showed elevated leukocytes and traces of blood. is this definitely uti? other possibilities?

UTI: Most likely a UTI, final definite answer needs urine culture to confirm infection and type of bacteria and the best antibiotic to treat the infection with

Not definitely UTI: Leukocytes in urine can come from skin flora if not cleaned properly and trace blood can come from straining, A urine culture is definite test for UTI and presence of leukocyte esterase and /or nitrites in a urinalysis are good indicators for a UTI.

Irritated bottom: These girls often sit in soapy bathwater & fail to rinse their genitals as they leave. This leads to irritation/genital itching later. This can abrade the pee hole & produce these findings. They can also wipe wrong or react to scented soaps. I find about 10 of these for each UTI. Only a good clean catch or cath urine can adequately dx a UTI at this age. A typical squat pee office collection won't