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In the Department of Paediatrics at Hillerød a valid diagnosis of urinary tract infection in children is defined to be at least 10.000 bacteria/ml. in two midstream specimens of urine or any bacterial growth in urine collected by a suprapubic aspiration or by bladder catheterisation. We decided to study if these criteria were fulfilled in our department, which takes care of urinary tract infections in children in the county of Frederiksborg with a catchment area of about 350.000 people. From 1994-1996 a total of 60 children younger than two years of age were treated for their first suspected urinary tract infection. The diagnosis was valid in 37% of the cases. Eighty-eight percent of the children received parenteral antibiotics for at least three days, and 86% were discharged with prophylactic antibiotics. All underwent urological ultrasonographic examination and 70% underwent an isotope micturition cystourethrography. Among patients with a valid diagnosis 68% were boys and 50% had urological abnormalities, whereas among patients without a valid diagnosis there were 33% boys (p < 0.025) and 24% had urological abnormalities (p = 0.0734). A valid diagnosis of a first urinary tract infection was established in 0.15% of children younger than two years of age in the county of Frederiksborg. This is lower than previously reported. The problem of false positive urinary tract infections thus may be important in general.

The purpose of this study was to investigate frequency and pattern of urological abnormalities in children younger than two years of age in the county of Frederiksborg, Denmark, with a catchment area of about 350,000 people, and furthermore to investigate in which way the urological abnormalities were diagnosed. From 1994-1996 a total of 35 children younger than two years of age were found to have urological abnormalities. Fourteen patients had a ultrasonographical prenatally diagnosed urological abnormality, which was confirmed postnatally. Twenty-one children were diagnosed with urological abnormalities after presentry with their first urinary tract infection. The obstructive urological diagnoses: congenital hydronephrosis, congenital megaureter and posterior urethral valves made up to 57% (20/35) of the abnormalities. Nine boys were operated upon; three for unilateral hydronephrosis, two for posterior urethral valves, one for unilateral megaureter and three for phimosis. Two girls were treated with oestrogen for labial fusion. Urological abnormalities which were treated were found among the ultrasonographically diagnosed abnormalities, apart from phimosis and labial fusion. The frequency of urological abnormalities was 0.25% in children younger than two years of age in Frederiksborg county. In conclusion, in 1994-1996 the frequency and pattern of urological abnormalities in Frederiksborg county was in accordance with the figures in the literature. Urological abnormalities requiring treatment were diagnosed in 11 children; 55% (6/11) ultrasonographically and 45% (5/11) by examination of the external genitalia of children younger than two years of age at the time of the first diagnosed urinary tract infection.

Observation of preschool children (SBO) consists of multidisciplinary assessment of whether a child aged 0-7 years is developmentally retarded and requires special training. For this observation, the children are admitted as day patients and, in the course of four days, the motor, mental, linguistic and social developments are assessed and sight and hearing are assessed. A few days after this observation, a conference is held and the result of assessment is discussed and the necessary measures to be instituted considered. During the years, 1987-1988, a total of 47 children were admitted for observation on account of suspected retarded development. Twenty-one of the children were found to be generally psychomotorically handicapped and of these 16 children were, mentally retarded. Three children suffered from benign hypotonia. Seventeen children were dysphatic and eight of these had also hypotonia. Six children had behaviour difficulties. The measures recommended are reviewed. Where 42 of the children were concerned, these were instituted with benefit to the child and his family.