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Urinary Tract Infections

  1. Infections are caused by Escherichia coli, followed by Klebsiella and Proteus.
  2. Staphylococcus saprophyticus is a pathogen in both sexes.
  3. Viral infections, particularly adenovirus, may also occur, especially as a cause of cystitis. 

Risk Factors for Urinary Tract Infection

  1. Female                                        
  2. Vesicoureteral reflux*
  3. Obstructive uropathy                                    
  4. Urethral instrumentation
  5. Pinworm infestation                                      
  6. P fimbriated bacteria*
  7. Anatomic abnormality (e.g., labial adhesion)        
  8. Neuropathic bladder
  9. Sexual activity                                              
  10. Pregnancy
    1. The goal of imaging studies in children with a UTI is to identify anatomic abnormalities that predispose to infection.
    2. A renal ultrasonogram should be obtained to rule out hydronephrosis and renal or perirenal abscesses.
    3. 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.


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