Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- fever >102.2°F (>39°C)
- irritability (neonates and infants)
- poor feeding (neonates and infants)
- suprapubic tenderness
- costovertebral angle tenderness
Другие диагностические факторы
- 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)
Факторы риска
- 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
Диагностические исследования
Исследования, которые показаны в первую очередь
- urine dipstick
- urine microscopy
- urine culture
Исследования, проведение которых нужно рассмотреть
- 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)
Алгоритм лечения
vesicoureteral reflux: no history of febrile UTIs
age ≤2 months
age >2 months
recurrent UTIs
Составители
Авторы
Joana Dos Santos, MD, MHSc, FRCPC
Assistant Professor of Pediatrics
Medical Pediatric Urologist
The Hospital for Sick Children
Toronto
Ontario
Canada
Раскрытие информации
JDS declares that she has no competing interests.
Выражение благодарностей
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.
Раскрытие информации
BG, FK, MAJ, and RV declare that they have no competing interests.
Рецензенты
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
Раскрытие информации
MK declares that he has no competing interests.
Daniel T. Keefe, MD, FRCSC
Pediatric Urology Fellow
The Hospital for Sick Children
Toronto
Ontario
Canada
Раскрытие информации
DTK declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
European Association of Urology. Guidelines on paediatric urology. 2024 [internet publication].Полный текст
National Institute for Health and Care Excellence. Urinary tract infection in under 16s: diagnosis and management. Jul 2022 [internet publication].Полный текст
Mattoo TK, Shaikh N, Nelson CP. Contemporary management of urinary tract infection in children. Pediatrics. 2021 Feb;147(2):e2020012138.Полный текст Аннотация
American College of Radiology. ACR appropriateness criteria: urinary tract infection - child. 2023 [internet publication].Полный текст
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].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Appendicitis
- Gastroenteritis
- Kawasaki disease
Больше DifferentialsGuidelines
- Paediatric urology: urinary tract infections in children
- Guidelines on paediatric urology: urinary tract infections in children
Больше GuidelinesPatient information
Urinary tract infections in children
More Patient informationLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer