Urinary Tract Infections
- Infections are caused by Escherichia coli, followed by Klebsiella and Proteus.
- Staphylococcus saprophyticus is a pathogen in both sexes.
- Viral infections, particularly adenovirus, may also occur, especially as a cause of cystitis.
Risk Factors for Urinary Tract Infection
- Vesicoureteral reflux*
- Obstructive uropathy
- Urethral instrumentation
- Pinworm infestation
- P fimbriated bacteria*
- Anatomic abnormality (e.g., labial adhesion)
- Neuropathic bladder
- Sexual activity
- The goal of imaging studies in children with a UTI is to identify anatomic abnormalities that predispose to infection.
- A renal ultrasonogram should be obtained to rule out hydronephrosis and renal or perirenal abscesses.
- A voiding cystourethrogram (VCUG) is also indicated in all children younger than 5 yr with a UTI, any child with a febrile UTI, school-aged girls who have had two or more UTIs, and any male with a UTI. When the diagnosis of acute pyelonephritis is uncertain, renal scanning with technetium-labeled DMSA or glucoheptonate is useful.