Recommended imaging schedule for infants and children 6 months or older but younger than 3 years
Test | Responds well to treatment within 48 hours | Atypical UTI* | Recurrent UTI* |
Ultrasound during the acute infection | No | Yes*** | No |
Ultrasound within 6 weeks | No | No | Yes |
DMSA 4-6 months following the acute infection | No | Yes | Yes |
MCUG | No | No** | No** |
*
- atypical UTI includes:
- seriously ill
- poor urine flow
- abdominal or bladder mass
- raised creatinine
- septicaemia
- failure to respond to treatment with suitable antibiotics within 48 hours
- infection with non-E. coli organisms
- recurrent UTI:
- two or more episodes of UTI with acute pyelonephritis/upper urinary tract infection, or
- one episode of UTI with acute pyelonephritis/upper urinary tract infection plus one or more episode of UTI with cystitis/lower urinary tract infection, or
- three or more episodes of UTI with cystitis/lower urinary tract infection
**
while MCUG should not be performed routinely it should be considered if the following features are present:
- dilatation on ultrasound
- poor urine flow
- non-E. coli-infection
- family history of VUR
***
in an infant or child with a non-E. coli-UTI, responding well to antibiotics and with no other features of atypical infection, the ultrasound can be requested on a non-urgent basis to take place within 6 weeks
Reference
- NICE. Urinary tract infection in under 16s: diagnosis and management. NICE guideline NG224. Published July 2022
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