Imaging strategies and discussion of vesicoureteric reflux as a risk factor in the evaluation of urinary tract infection in children.
The relationship of urinary tract infection and vesicoureteric reflux with the potential for renal scarring and serious sequelae is well known. Evaluation of the child with urinary tract infection and identification of those at risk for infection are of paramount importance. With early diagnosis and early institution of proper therapy, the likelihood of renal scarring can be significantly reduced, and thus outcome can be improved. This review points to the controversies surrounding the ability to accurately distinguish between upper and lower tract urinary infection, and whether this distinction is important in the care of the child with urinary infection. Vesicoureteric reflux as a risk factor is discussed. Ultrasound examination and voiding cystourethrogram or radionuclide cystogram are generally recommended for evaluating the lower urinary tract of infants and preschool children who have urinary tract infection. The role of dimercaptosuccinic acid scanning in evaluating the upper tract is debated.
Preston
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Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1088.
D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012307:Risk Factors; D012680:Sensitivity and Specificity; D004113:Succimer; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014563:Urodynamics; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology
D004113:Succimer