recommended imaging schedule for infants and children 6 months or older but younger than 3 years

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 infectionNoYesYes
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

**

while MCUG should not be performed routinely it should be considered if the following features are present:

  • dilatation on ultrasound
  • poor urine flow
  • non-E. coli-infection
  • family history of VUR

***

in an infant or 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