Evidence-Based Imaging of Urinary Tract Infection in Infants and Children

Urinary tract infection (UTI) is defined as inflammation/infection of the urinary tract with confirmed growth of a single pathogen obtained from an adequate urine specimen. UTI is one of the most common bacterial infections in children and is usually the result of retrograde ascension of uropathogens from the fecal flora to the urinary system. UTI results from the imbalance between host defense and bacterial virulence factors. Escherichia coli is the most common uropathogen and is found in approximately 80–90% of UTI cases. The role of imaging in the diagnosis and management of febrile UTI is to diagnose underlying renal or urinary tract anomalies that can help explain the febrile UTI, to diagnose complications such as an abscess, and to assess the extent of renal injury in the case of recurrent UTIs. Renal bladder ultrasound (RBUS) is the first imaging test of choice.