Urinary tract infection

Abstract The diagnosis of a urinary tract infection (UTI) should be carefully considered and based on appropriate urine collection and urinalysis or urine culture. There is an association between UTIs and underlying urological anomalies and renal scarring. Therefore, all children who have experienced a UTI should be seen and evaluated. A child who does not settle quickly on appropriate treatment needs to have urgent renal ultrasonography to exclude a urinary tract obstruction. Ultrasonography is always the investigation of first choice for recurrent UTIs but can miss vesico-ureteric reflux and scarring. More invasive investigations should not be performed on all children presenting with a first UTI. They should be tailored towards those children likely to benefit from treatment. A full evaluation in an older child includes an assessment of voiding function and toileting habit. An acute abdomen may present with signs and symptoms of a UTI, leading to a misdiagnosis.