A practical approach to evaluating urinary tract infection in children
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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 wordsUrinary tract infection Urography Cysto-urethrography Ultrasonography Radionuclide scan
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