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Pediatric Nephrology

, Volume 5, Issue 4, pp 401–402 | Cite as

A practical approach to evaluating urinary tract infection in children

  • George B. Haycock
Original Article Practical Pediatric Nephrology

Abstract

All children with urinary tract infections should be investigated byeither excretory urographyor abdominal X-ray, ultrasonography and technetium 99 m—dimercaptosuccinic acid scintigraphy. Patients in the following categories should also have micturating (voiding) cystourethrography to diagnose or exclude vesico-ureteral reflux: infants aged less than 1 year, children with recurrent (second or subsequent) infections, children with clinically diagnosed acute pyelonephritis and those with a family history of reflux or chronic pyelonephritis. Cystography can safely be omitted in children over 1 year of age with unscarred kidneys and none of the additional risk factors listed. They should be followed for 1–2 years following the first infection for evidence of recurrence.

Key words

Urinary tract infection Urography Cysto-urethrography Ultrasonography Radionuclide scan 

References

  1. 1.
    Dickinson JA (1979) Incidence and outcome of symptomatic urinary tract infection in children. Br Med J 1: 1330–1332PubMedGoogle Scholar
  2. 2.
    Jacobson SH, Eklöf U, Eriksson CG, Lins L-E, Tidgren B, Winberg J (1989) Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. Br Med J 299: 703–706Google Scholar
  3. 3.
    Broyer M, Rizzoni G, Brunner FP, Brynger H, Challah S, Fassbinder W, Oulès R, Selwood NH, Wing AJ (1985) Combined report on regular dialysis and transplantation of children in Europe, XIV, 1984. Proc Eur Dial Transplant Assoc 22: 55–79Google Scholar
  4. 4.
    Heale WF (1977) Hypertension and reflux nephropathy. Aust Paediatr J 13: 56Google Scholar
  5. 5.
    Haycock GB (1986) Investigation of urinary tract infection. Arch Dis Child 61: 1155–1158PubMedGoogle Scholar
  6. 6.
    Ransley PG, Risdon PA (1978) Reflux and renal scarring. Br J Radiol 51 [Suppl 14]: 1–35PubMedGoogle Scholar
  7. 7.
    Blickman JG, Taylor GA, Lebowitz RL (1985) Voiding cystourethrography: the initial radiologic study in children with urinary tract infection. Radiology 156: 659–662PubMedGoogle Scholar
  8. 8.
    Smellie JM, Normand ICS (1985) Urinary infections in children 1985. Postgrad Med J 61: 895–905PubMedGoogle Scholar
  9. 9.
    McAlister WH, Cacciarelli A, Shackleford GD (1974) Complications associated with cystography in children. Radiology 111: 167–172PubMedGoogle Scholar
  10. 10.
    Chapman SJ, Chantler C, Haycock GB, Maisey MN, Saxton HM (1988) Radionuclide cystography in vesicoureteric reflux. Arch Dis Child 63: 650–671PubMedGoogle Scholar
  11. 11.
    Moncrieff MW, Whitelaw R (1976) Value of cystography in urinary tract infections. Arch Dis Child 51: 893–895PubMedGoogle Scholar
  12. 12.
    Cavanagh PM, Sherwood T (1983) Too many cystograms in the investigation of urinary tract infection in children? Br J Urol 55: 217–219PubMedGoogle Scholar
  13. 13.
    Drew JH, Acton CM (1976) Radiological findings in newborn infants with urinary infection. Arch Dis Child 51: 628–630PubMedGoogle Scholar
  14. 14.
    Bourchier D, Abbott GD, Maling TMJ (1984) Radiological abnormalities in infants with urinary tract infection. Arch Dis Child 59: 620–624PubMedGoogle Scholar
  15. 15.
    Smellie JM, Ransley PG, Normand ICS, Prescod N, Edwards D (1985) Development of new renal scars: a collaborative study. Br Med J 290: 1957–1960Google Scholar
  16. 16.
    Berg UB, Johansson SB (1983) Age as a main determinant of renal functional damage in urinary tract infection. Arch Dis Child 58: 963–969PubMedGoogle Scholar
  17. 17.
    Aggarwal VK, Verrier Jones K (1989) Vesicoureteric reflux: screening of first degree relatives. Arch Dis Child 64: 1538–1541PubMedGoogle Scholar

Copyright information

© IPNA 1991

Authors and Affiliations

  • George B. Haycock
    • 1
  1. 1.Department of Paediatrics, United Medical and Dental Schools of Guy's and St. Thomas's HospitalsGuy's HospitalLondonUK

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