Imaging in children with UTI: NICE guidance

Ultrasonography: Everyone <6 months, and recurrent infections (see below) in children >6 months.


Urgent ultrasonography (at time of the infection): < 3 yrs with atypical infection (see below) or <6 months with with recurrent infection (see below).



Atypical infection – any of the following:


  • No response to 48 hrs appropriate antibiotic treatment

  • Poor urine flow

  • Bladder/abdominal mass

  • Non-E. Coli organism

  • Septicaemia

  • Raised serum creatinine



Recurrent infection: 3 or more episodes of LUTI, or 2 episodes UTI if either of them was an upper UTI.



Micturating cystography – gold standard (if done by a skilled radiologist) but invasive (requires catheterisation) and involves ionising radiation (equivalent to about 4/12 background radiation). Indications: <6/12 with atypical infection or recurrent infection. Consider if abnormal ultrasound.



DMSA – < 3 years with atypical or recurrent UTIs. (Looks for scarring.)


(BMJ 2013; 346: e8654 doi: 10.1136/bmj.e8654)


About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in BMJ, Credits 2013, Paediatrics, Radiology, Urology. Bookmark the permalink.

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