recommended imaging schedule for children 3 years or older

Last reviewed 01/2018

TestResponds well to treatment within 48 hoursAtypical UTI*Recurrent UTI*
Ultrasound during the acute infectionNoYes**, ***No
Ultrasound within 6 weeksNoNoYes **
DMSA 4-6 months following the acute infectionNoNoYes
MCUGNoNo**No

*

  • atypical UTI includes:
    • seriously ill
    • poor urine flow
    • abdominal or bladder mass
    • raised creatinine
    • septicaemia
    • failure to respond to treatment with suitable antibiotics within 48 hours
    • infection with non-E. coli organisms
  • recurrent UTI:
      • two or more episodes of UTI with acute pyelonephritis/upper urinary tract infection, or
      • one episode of UTI with acute pyelonephritis/upper urinary tract infection plus one or more episode of UTI with cystitis/lower urinary tract infection, or
      • three or more episodes of UTI with cystitis/lower urinary tract infection.

** ultrasound in toilet-trained children should be performed with a full bladder with an estimate of bladder volume before and after micturition

*** in a child with a non-E. coli-UTI, responding well to antibiotics and with no other features of atypical infection, the ultrasound can be requested on a non-urgent basis to take place within 6 weeks

Reference:

  1. NICE (September 2017).Urinary tract infection in children: diagnosis, treatment and long-term management