BMJ 1994;309:609 (3 September)

Letters

Urinary tract infection in children How vigorous should investigation be?

EDITOR, - J M Smellie and colleagues concluded that it is essential to identify vesicoureteric reflux early by cystography in infants with antenatal dilatation of the urinary tract, infants and young children after a first urinary tract infection, and siblings and offspring of patients with renal scarring.1 They reiterated that ultrasonographic imaging is inadequate to exclude renal scarring. A paper from Gothenburg confirms that even experienced radiologists frequently fail to find renal scars.2

In general radiological practice plain radiography and ultrasound examination of the renal tract seem to be a practical means of identifying children who need surgical intervention to correct obstruction, calculus, severe anomaly, or gross reflux.3 If the remaining children are treated with antibiotics until the infection has stopped is there a need to investigate and monitor them with such vigour?

Before we devote so much of our limited radiological resources and so much radiation to this cause . . . [Full text of this article]


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Relevant Article

Retrospective study of children with renal scarring associated with reflux and urinary infection
J M Smellie, A Poulton, and N P Prescod
BMJ 1994 308: 1193-1196. [Abstract] [Full Text]

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