title: Update on the approach of urinary tract infection in childhood.
abstract: OBJECTIVE
  Urinary tract infection (UTI) is the most common bacterial infection in childhood. UTI may be the sentinel event for underlying renal abnormality. There are still many controversies regarding proper management of UTI. In this review article, the authors discuss recent recommendations for the diagnosis, treatment, prophylaxis, and imaging of UTI in childhood based on evidence, and when this is lacking, based on expert consensus.
  
  
  METHODS
  Data were obtained after a review of the literature and a search of Pubmed, Embase, Scopus, and Scielo.
  
  
  RESULTS
  In the first year of life, UTIs are more common in boys (3.7%) than in girls (2%). Signs and symptoms of UTI are very nonspecific, especially in neonates and during childhood; in many cases, fever is the only symptom.
  
  
  CONCLUSIONS
  Clinical history and physical examination may suggest UTI, but confirmation should be made by urine culture, which must be performed before any antimicrobial agent is given. During childhood, the proper collection of urine is essential to avoid false-positive results. Prompt diagnosis and initiation of treatment is important to prevent long-term renal scarring. Febrile infants with UTIs should undergo renal and bladder ultrasonography. Intravenous antibacterial agents are recommended for neonates and young infants. The authors also advise exclusion of obstructive uropathies as soon as possible and later vesicoureteral reflux, if indicated. Prophylaxis should be considered for cases of high susceptibility to UTI and high risk of renal damage.
authors.affiliation: Department of Pediatrics, Unit of Pediatric Nephrology, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Electronic address: acssilva@hotmail.com.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões e Silva
authors.affiliation: Department of Pediatrics, Unit of Pediatric Nephrology, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Eduardo Araújo
authors.initials: EA
authors.lastname: Oliveira
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000473:pathology; D008297:Male; D012008:Recurrence; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D059349:Urine Specimen Collection / Q000379:methods; D014564:Urogenital Abnormalities / Q000000981:diagnostic imaging / Q000517:prevention & control; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents
keywords: CAKUT; Cicatriz renal; Hidronefrose; Hydronephrosis; Infecção do trato urinário; Obstructive uropathy; Renal scarring; Ultrasonography; Ultrassonografia; Urinary tract infection; Uropatia obstrutiva