Urinary tract infection in children: investigation Flashcards
Urinary tract infection in children: investigation
NICE guidelines for imaging the urinary tract
infants < 6 months who present with a first UTI which responds to treatment should have an ultrasound within 6 weeks
children > 6 months who present with a first UTI which responds to treatment do not require imaging unless there are features suggestive of an atypical infection (see below) or recurrent infection
Features of suggestive of an atypical infection
seriously ill
poor urine flow
abdominal or bladder mass
raised creatinine
septicaemia
failure to respond to treatment with suitable antibiotics within 48 hours
infection with non-E. coli organisms
Possible further investigations
urine for microscopy and culture: urine should be sent for culture as only 50% of children with a UTI have pyuria. Microscopy or dipstick of the urine is therefore inadequate for diagnosis
static radioisotope scan (e.g. DMSA): identifies renal scars. Should be done 4-6 months after initial infection
micturating cystourethrography (MCUG): identifies vesicoureteric reflux. Only recommended for infants younger than 6 months who present with atypical or recurrent infections
