Related Experiment Videos
A practical approach to evaluating urinary tract infection in children
1Department of Paediatrics, United Medical School, Guy's Hospital, London, UK.
Pediatric Nephrology (Berlin, Germany)
|July 1, 1991
Summary
All children with urinary tract infections (UTIs) need imaging tests. Specific groups, including infants and those with recurrent infections, require further investigation for vesico-ureteral reflux to prevent kidney damage.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging in Children
- Urinary Tract Infections
Background:
- Urinary tract infections (UTIs) are common in children.
- Prompt diagnosis and management are crucial to prevent renal scarring and long-term complications.
- Identifying children at risk for vesico-ureteral reflux (VUR) is essential.
Purpose of the Study:
- To outline recommended diagnostic imaging strategies for children with UTIs.
- To identify specific patient subgroups requiring micturating cystourethrography (MCU) for VUR diagnosis.
- To define criteria for safely omitting MCU in certain pediatric UTI cases.
Main Methods:
- Review of diagnostic guidelines for pediatric UTIs.
- Recommendation of excretory urography or abdominal X-ray, ultrasonography, and technetium 99m - dimercaptosuccinic acid scintigraphy for all UTIs.
- Indication of micturating (voiding) cystourethrography for specific high-risk groups.
Main Results:
- All children with UTIs require initial imaging (excretory urography/X-ray, ultrasound, DMSA scan).
- Micturating cystourethrography is recommended for infants <1 year, recurrent UTIs, acute pyelonephritis, and family history of VUR/pyelonephritis.
- Cystography can be omitted in children >1 year with unscarred kidneys and no additional risk factors.
Conclusions:
- A tiered approach to imaging is recommended for pediatric UTIs.
- Early identification of VUR through appropriate cystography is vital for select pediatric patients.
- Follow-up for 1-2 years post-first infection is advised to monitor for recurrence.