Abstract

Around 3-5% of girls and 1-2% of boys will have a symptomatic urinary tract infection during childhood.1 Infection is important not just as a cause of troublesome and often recurrent symptoms but also because it can point to unsuspected abnormalities of the urinary tract. The most common of these is vesicoureteric reflux. In a minority of children, especially among those under 2 years old with reflux, infection of the upper urinary tract leaves the kidneys permanently scarred (chronic atrophic pyelonephritis; reflux nephropathy). Such scarring occasionally leads to the development of hypertension or renal failure later in childhood or in early adulthood. In the very young, urinary infection often presents with non-specific symptoms and is easily missed. In this article, we consider the causes and outcome of urinary tract infection in children and discuss its diagnosis and management.