Clujul Medical - Iuliu Haţieganu

Clujul Medical 2006 vol. LXXX - nr. 1
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The urinary tract infection and the reflux nephropathy in
children
RODICA MANASIA
Summary
Urinary tract infection (UTI) is relatively frequent in children. The symptoms
are often atypical; the more so, the younger the child. The UTI is often associated with
functional or malformative uropathy, such as vesico-ureteral reflux or obstruction.
Radiological investigation should be carried out in every child presenting with his first
UTI. The prognosis of uncomplicated UTI is very good, but is less favorable when UTI
is associated with urological abnormalities. Development of pielonephritic lesions can
lead to kidney scarring for which the occurence of intrarenal reflux associated with a
specific type of pappila, is probably responsible. Short-term treatment is recommended
for uncomplicated UTI. Uncomplicated UTI with frequent relapses or UTI associated
with vesico-ureteral reflux requires prophylactic chemotherapy. Worsening of reflux
and/or development of pielonephritic lesions while on prophylactic treatment are an
indication for surgical intervention. Surgery is always indicated in the presence of a
major urological malformation. Be it medical or surgical, treatment of UTI should
always be followed by regular urine cultures for several years.
Keywords: urinary tract infection, vesico-ureteral reflux, pielonephritic
lesions, child.
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