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Urinary tract infection - children - Management
What imaging tests, and when, for children over 3 years of age with a urinary tract infection?
- Imaging tests used to investigate children with urinary tract infection include ultrasonography of the kidneys, ureters, and bladder; DMSA (dimercaptosuccinic acid) scintigraphy; and micturating cystourethrography.
- In primary care, it is rarely necessary to arrange (or refer for) imaging tests because the infants or children that require an imaging test are usually already being managed in secondary care. However, the recommended criteria for imaging are listed in Table 1 for ease of reference.
Table 1. Imaging schedule recommended by NICE for children over 3 years of age with a urinary tract infection.
Imaging test | Responds well to treatment within 48 hours | Atypical urinary tract infection | Recurrent urinary tract infection |
|---|
Ultrasonography during the acute infection | No | Yes*† | No |
Ultrasonography within 6 weeks | No | No | Yes* |
DMSA (dimercatosuccinic acid) scintigraphy 4–6 months after acute infection | No | No | Yes |
Micturating cystourethrography | No | No | No |
* Ultrasonography in toilet-trained children should be performed with a full bladder with an estimate of bladder volume before and after micturition. † In an infant or child with a non–Escherichia coli urinary tract infection who is responding well to antibiotics and has no other features of atypical infection, ultrasonography can be requested on a non-urgent basis to take place within 6 weeks. |
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For further information, see Atypical urinary tract infection, and Recurrent urinary tract infection.
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