Referral criteria from primary care - UTI in a child

Some suggest that all children (boys and girls) should undergo appropriate investigations after the first proven UTI (1). However NICE guidance states imaging varies with respect to age of the child and features of the UTI (2).

With respect to the acute presentation of a possible UTI in a child (2):

• infants and children with a high risk of serious illness should be referred urgently to the care of a paediatric specialist
  
  
• infants younger than 3 months with a possible UTI should be referred immediately to the care of a paediatric specialist. Treatment should be with parenteral antibiotics
  
  
• for infants and children 3 months or older with acute pyelonephritis/upper urinary tract infection:
  • consider referral to a paediatric specialist

Reference:

1. Watson AR (2004). Pediatric urinary tract infection. EAU Update Series.
2. NICE (September 2017).Urinary tract infection in children: diagnosis, treatment and long-term management