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[Recurrent urinary tract infection in childhood. Diagnosis, treatment, prognosis (author's transl)]
Insights
Childhood urinary tract infections (UTIs) are common and can be asymptomatic. Early UTIs in infants may present with vague symptoms, and recurrences are often silent, potentially leading to kidney damage.
Area of Science:
- Pediatrics
- Nephrology
- Infectious Diseases
Context:
- Childhood urinary tract infections (UTIs) are a frequent occurrence, affecting neonates and infants.
- Clinical presentation of UTIs in children can be non-specific, especially in early life, including fever and neurological signs.
- Asymptomatic bacteriuria, the presence of bacteria in urine without symptoms, can occur at any age.
Purpose:
- To highlight the diagnostic challenges and potential long-term consequences of childhood urinary tract infections.
- To emphasize the significance of asymptomatic bacteriuria and its association with recurrent infections.
- To underscore the importance of early and accurate diagnosis for effective treatment and prevention of complications.
Summary:
- Urinary tract infections (UTIs) in children, particularly in early infancy, often present with atypical symptoms.
- Asymptomatic bacteriuria is common and recurrences are frequently silent, posing a diagnostic challenge.
- Diagnostic methods like mid-stream urine specimens and suprapubic aspiration are crucial for timely and specific therapy.
Impact:
- Early recognition and treatment of childhood UTIs can prevent serious complications like pyelonephritis and pyelonephritic nephrosis.
- Understanding asymptomatic bacteriuria is key to managing recurrent infections and safeguarding renal health in children.
- This research emphasizes the need for vigilant monitoring and prompt intervention in pediatric urinary tract infections to prevent long-term kidney damage.
Abstract:
Infection of the urinary tract in childhood is common. It may start already in neonates or infants. Clinical signs are not always present but asymptomatic socalled bacteriuria may occur at any age. The earlier a child contracts the infection the more common are uncharacteristic clinical signs like loss of appetite, a raised temperature, parenchymatous icterus and, finally signs of involvement of the central nervous system. During the last few years purposeful research has established the important fact that, if there has been a urinary tract infection particularly in the first months of life, recurrence may more often be asymptomatic than on the first occasion. A mid-stream specimen is diagnostically valuable. If this does contain any bacteria, then supapubic aspiration from the bladder is useful in enabling us to start a specific, if possible bactericidal, therapy. Asymptomatic bacteriuria may at any time lead to clinical signs of pyelonephritis, particularly during periods of stress. Such silent unrecognized cases of asymptomatic bacteriuria may, we feel, lead to pyelonephritic nephrosis in a so far unknown percentage of cases.