UTI in infants and very young children is often renal in nature and may be associated with generalised symptoms such as fever, vomiting, diarrhoea and failure to thrive. Symptoms of dysuria and frequency appear only after the age of 2 years when the child is able to indicate the source of the discomfort. In a girl or boy (rare presentation) with symptoms of dysuria and frequency an underlying abnormality is likely to be present with a reported incidence of vesicoureteric reflux as high as 40% and scarred kidneys (reflux nephropathy) in 27%. 3
Thus the early detection of children with vesicoureteric reflux and control of recurrent renal infection could prevent the development of scars, hypertension and chronic renal failure. Radiological investigation of children with UTIs shows normal kidneys in approximately 66% and reflux in approximately 33%.
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