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[Urinary tract infections in children].

Albert Bensman1

  • 1Service de néphrologie pédiatrique, hôpital Trousseau, 75012 Paris. a.bensman@trs.ap-hop-paris.fr

La Revue Du Praticien
|May 12, 2004
PubMed
Summary

Diagnosing urinary tract infections (UTIs) involves urine culture colony counts and clinical signs. Treatment varies by infection type (cystitis or pyelonephritis) and patient factors, often including imaging and oral or parenteral antibiotics.

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Area of Science:

  • Urology
  • Infectious Diseases
  • Pediatrics

Context:

  • Urinary tract infections (UTIs) are common in children, necessitating accurate diagnosis and management.
  • Diagnosis relies on quantitative urine cultures and characteristic clinical/biological signs.
  • Identifying underlying uropathies is crucial after a UTI episode.

Purpose:

  • To outline diagnostic criteria for UTIs, including cystitis and pyelonephritis.
  • To detail recommended investigations for children with UTIs.
  • To describe current antimicrobial treatment strategies based on UTI type and severity.

Summary:

  • UTI diagnosis uses urine culture colony counts (>10^5/mL for clean catch/bag, >10^4/mL for catheterization).
  • Clinical signs (fever, pain) and elevated inflammatory markers support diagnosis.
  • Post-UTI evaluation includes imaging (sonogram, VCUG) to detect lithiasis, reflux, or obstruction.
  • Cystitis is treated orally; pyelonephritis often starts with parenteral antibiotics then oral therapy.
  • Oral antibiotics may be initiated for non-toxic children over 18 months without severe uropathy.

Impact:

  • Establishes clear diagnostic and management guidelines for pediatric UTIs.
  • Promotes timely and appropriate treatment, potentially reducing complications.
  • Highlights the importance of investigating for structural or functional abnormalities post-UTI.

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