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Urinary tract infections in children

Última revisão: 13 Jun 2025
Última atualização: 05 Jun 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • fever >102.2°F (>39°C)
  • irritability (neonates and infants)
  • poor feeding (neonates and infants)
  • suprapubic tenderness
  • costovertebral angle tenderness
Detalhes completos

Outros fatores diagnósticos

  • foul-smelling urine (infants, older children, and adolescents)
  • dysuria (preschool age, older children, and adolescents)
  • urinary frequency (older children and adolescents)
  • abdominal/flank pain (infants, older children, and adolescents)
  • vomiting
  • ill appearance (neonates)
  • gross hematuria (older children and adolescents)
  • new-onset urinary incontinence (toddlers, older children, and adolescents)
Detalhes completos

Fatores de risco

  • age <1 year
  • female sex
  • uncircumcised boys in the first year of life
  • previous UTI
  • bladder and bowel dysfunction
  • vesicoureteral reflux
  • sexual activity
  • no history of breastfeeding
  • anatomic abnormalities or previous surgery to the urinary tract
  • immunosuppression
  • protein-energy malnutrition
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • urine dipstick
  • urine microscopy
  • urine culture
Detalhes completos

Investigações a serem consideradas

  • urine flow cytometry
  • blood culture
  • complete blood count
  • inflammatory markers
  • fungus urine culture
  • serum creatinine, BUN and electrolytes
  • renal and/or bladder ultrasound
  • dimercaptosuccinic acid (DMSA) scan
  • voiding cystourethrogram (VCUG)
Detalhes completos

Algoritmo de tratamento

Inicial

vesicoureteral reflux: no history of febrile UTIs

AGUDA

age ≤2 months

age >2 months

CONTÍNUA

recurrent UTIs

Colaboradores

Autores

Joana Dos Santos, MD, MHSc, FRCPC

Assistant Professor of Pediatrics

Medical Pediatric Urologist

The Hospital for Sick Children

Toronto

Ontario

Canada

Declarações

JDS declares that she has no competing interests.

Agradecimentos

Dr Joana Dos Santos would like to gratefully acknowledge Dr Beatrice Goilav, Dr Frederick Kaskel, Dr Mary Anne Jackson, and Dr Rene VanDeVoorde, previous contributors to this topic.

Declarações

BG, FK, MAJ, and RV declare that they have no competing interests.

Revisores

Martin Koyle, MD, MSc, FAAP, FACS, FRCS(Eng), FRCSC

Professor

Department of Surgery and Institute of Health Policy, Management and Evaluation

Staff Pediatric Urologist

The Hospital for Sick Children

Toronto

Ontario

Canada

Declarações

MK declares that he has no competing interests.

Daniel T. Keefe, MD, FRCSC

Pediatric Urology Fellow

The Hospital for Sick Children

Toronto

Ontario

Canada

Declarações

DTK declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

European Association of Urology. Guidelines on paediatric urology. 2024 [internet publication].Texto completo

National Institute for Health and Care Excellence. Urinary tract infection in under 16s: diagnosis and management. Jul 2022 [internet publication].Texto completo

Mattoo TK, Shaikh N, Nelson CP. Contemporary management of urinary tract infection in children. Pediatrics. 2021 Feb;147(2):e2020012138.Texto completo  Resumo

American College of Radiology. ACR appropriateness criteria: urinary tract infection - child. 2023 [internet publication].Texto completo

Peters CA, Skoog SJ, Arant BS Jr, et al; American Urological Association. Management and screening of primary vesicoureteral reflux in children: AUA guideline. 2017 [internet publication].Texto completo

Artigos de referência

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