Urinary tract infection in childhood. A practical approach and pediatric urologists point of view.

Urinary tract infection is a common problem in infants and children; it is the 2nd most common infection in children; moreover, morbidity is not limited to the acute period of illness. Urinary tract infection may also result in renal scarring which has the potential for diminished renal function and hypertension. The significant morbidity from urinary tract infection in early childhood has led to our current recognition of the importance of early diagnosis, prompt antibiotic treatment, and thorough evaluation of urinary tract infections in young children with documented urinary tract infection. Especially important are the differences in urinary tract infection between adults and children that emphasize that children are not "little adults" and they need different management. The risk of renal scarring is greatest in infants and may be progressive if there is a delay in diagnosis and management of urinary tract infections in children. Normal anatomy and physiology of the urinary tract with unidirectional urinary flow and complete emptying at regular reasonable intervals should protect children from urinary tract infections. A normal child should not have urinary tract infection. The obvious goals of urinary tract infection management are to provide symptomatic relief and to prevent renal damage. In the meantime to be able to prevent the recurrences of urinary tract infection, we have to evaluate the patient more, looking for any structural or functional predisposing factors. Treatment of underlying voiding dysfunction and constipation is an essential component of successful management of urinary tract infections in children. We will elaborate on urinary tract infection in children and concentrate mainly on the pediatric urologists' point of view and our practical approach to this problem.