Dr. Sandra Vanin is assistant professor of adapted physical education, School of Physical Education, West Virginia University. See article on page 2405. Pennsylvania The article by Hellerstein 1 in this issue focuses on risk factors for urinary tract infection in children and reviews methods of prevention. Leaving aside the issue of circumcision and abnormal voiding patterns, this commentary will focus on the diagnosis of urinary tract infection in children and the selection of imaging procedures after diagnosis. See Article in this issue.
Infant girls are at a particularly high risk of urinary tract infection.
The incidence of urinary tract infection is higher during the first year of life than at any other age in childhood. Our initial study investigated the prevalence of urinary tract infections in febrile infants, with and without an apparent source of fever, who presented to the emergency department. Urine cultures obtained by catheter were positive in 5.3 percent of 945 infants with fever. 3 Diagnosis of urinary tract infection is a major issue, and it should be based on both the results of urinalysis and the results of culture of a properly collected urine specimen. Suprapubic aspiration may be necessary for preterm infants, girls who cannot be catheterized because of labial adhesions, uncircumcised boys with tight foreskins and children with various anatomic abnormalities.