[Recurrent urinary tract infection in childhood. Diagnosis, treatment, prognosis (author's transl)]

Abstract

Infection of the urinary tract in childhood is common. It may start already in neonates or infants. Clinical signs are not always present but asymptomatic socalled bacteriuria may occur at any age. The earlier a child contracts the infection the more common are uncharacteristic clinical signs like loss of appetite, a raised temperature, parenchymatous icterus and, finally signs of involvement of the central nervous system. During the last few years purposeful research has established the important fact that, if there has been a urinary tract infection particularly in the first months of life, recurrence may more often be asymptomatic than on the first occasion. A mid-stream specimen is diagnostically valuable. If this does contain any bacteria, then supapubic aspiration from the bladder is useful in enabling us to start a specific, if possible bactericidal, therapy. Asymptomatic bacteriuria may at any time lead to clinical signs of pyelonephritis, particularly during periods of stress. Such silent unrecognized cases of asymptomatic bacteriuria may, we feel, lead to pyelonephritic nephrosis in a so far unknown percentage of cases.