Clinical and Radiological Features of Urinary Infection in Childhood

Infection of the urinary tract is a common condition in childhood and one which is often overlooked. In a recent large survey significant bacteriuria was found in 1 % of a schoolgirl population, many of these children being symptomless (Kunin et al., 1962). De Luca et al. (1963) found an average delay in diagnosis of 18 months, and only 28% of Burke's (1961) series were referred with the correct diagnosis. In recent years we have become aware of typical pyelonephritic scarring in the excretory pyelograms of young children who have been investigated because of a urinary infec tion. The association with vesico-ureteric reflux in these cases (Hodson and Edwards, 1960) has also been impressive. At the same time the grave consequences of chronic pyelonephritis have attracted increasing attention, and chronic pyelonephritis is recognized as the commonest cause of hypertension and renal failure in young adults (Rosenheim, 1959). We therefore decided to study the clinical and radiological features of urinary infections in children in the hope that a better understanding of the natural history in this age-group might lead to improved management, the prevention of scarring, and a reduction in chronic pyelonephritis in later life.