Recurrent Urinary Tract Infection in Children. A Clinician's Approach

Urinary tract infection is one of the most common infections of childhood standing second to respiratory tract infection. Recurrent urinary Tract infection (RUTI) seen in 30 to 50 % of children, more commonly in infants. The dilemma that a clinician faces is how to manage recurrent Urinary tract infection (RUTI) as a febrile illness in the midst of child hood febrile pathologies of which viral illnesses account for the most?. Who to investigate and which child will need observation only? Consequences of recurrent febrile episode presenting as UTI may lead to renal scarring, compromised renal function and later hypertension due to loss of nephrons in adulthood. The National Institute of Health and Care Excellence (NICE) guidelines 2007 focus more on Urinary Tract Infection (UTI) diagnosis in general with details towards diagnosis and management. In clinical practice this is helpful in investigating and managing any case of UTI. The NICE guidelines comment on RUTI prevention and prophylaxis however, the details of approach for case of RUTI in detail are not present.