Urinary tract infection in childhood

Abstract

Urinary tract infections (UTIs) are very common in children and are caused by micro-organisms in the urinary tract, with Escherichia coli accounting for 85–90% of UTIs. The clinical presentation is variable depending on age and the location of the infection. UTIs are categorised as either upper or lower, with the former affecting the renal pelvis and kidneys, and the latter affecting the bladder and urethra. One of the difficulties in diagnosing UTIs in children is that the history and examination findings can be vague and non-specific; therefore, a urine sample is usually required, which is challenging to obtain in pre-continent children. If a UTI is missed, it can lead to renal scarring, hypertension, and end-stage renal disease. This article presents an overview of how to approach UTI in childhood to aid diagnosis and management, and thus to avoid any life-changing complications.