ABSTRACT
A lower urinary tract infection usually presents with frequency, dysuria, suprapubic pain and occasionally secondary enuresis. Features suggestive of an upper urinary tract infection, i.e. pyelonephritis, include loin pain, vomiting and fever. However, neonates and infants are more likely to present with non-specific signs of vomiting, irritability and fever. First-line investigation for a urinary tract infection is an ultrasound scan. However, current British NICE guidelines suggest that in a child over the age of 6 months no imaging is required for a first episode of uncomplicated urinary tract infection that responds well to treatment. Over the age of 6 months, a child with a urinary tract infection that is complicated or recurrent should have an ultrasound scan and a DMSA performed. Dilatation on the ultrasound scan or a family history of vesicoureteric reflux warrants micturating cystourethrogram (MCUG).
