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Urinary tract infection - children - Management
When should an infant less than 3 months of age with urinary tract infection have imaging tests?
- 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 who require an imaging test should already be being managed in secondary care. For ease of reference, Table 1 lists the criteria for imaging that are recommended by NICE [National Collaborating Centre for Women's and Children's Health, 2007].
Table 1. Imaging schedule recommended by NICE for infants less than 6 months old who have 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* | Yes |
Ultrasonography within 6 weeks | Yes† | No | No |
DMSA (dimercaptosuccinic acid) scintigraphy 4–6 months following the acute infection | No | Yes | Yes |
Micturating cystourethrography | No | Yes | Yes |
* 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. † If abnormal, consider micturating cystourethrography. |
|
For further information, see Atypical urinary tract infection, and Recurrent urinary tract infection.
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