Urinary Tract Infections in Children: Never Ending Story

Amira Peco-Antić

Abstract

The aim of this paper is to provide information from the most important literature on the diagnosis, treatment and further management  of urinary tract infections (UTI) in childhood. Following acute viral  respiratory tract infections, UTIs are the second, most common infections in children. After febrile UTI, up to 40% of children have permanent renal scarring that may lead to poor renal growth, arterial hypertension, preeclampsia and chronic renal failure. Diagnosis and management of UTI is still one of the most controversial topics of pediatrics. The recent recommendations for the diagnosis, treatment, prophylaxis, and imaging of UTI in childhood based on evidence, or on a consensus of experts are discussed in this review article.

Conclusion – Prompt diagnosis and treatment of UTI remain of utmost importance. Most existing guidelines recommend renal ultrasound after the first febrile UTI, but cystography only in the presence of risk factors or anomalies on ultrasound. There is still no consensus regarding antibiotic prophylaxis after the first episode of febrile UTI.

Keywords

Acute pyelonephritis; Cystitis; Renal and bladder ultrasound; Renal scarring in children; Voiding cystoureterography

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