Urinary tract infection in children: diagnosis, treatment, and long term management - in association with NICE

6 . W h ic h of t h e followin g st a t em en t s is c orrec t ?
Y o u r an s we r a. b. c. d. e. Co r r e ct an s we r

The child should have an immediate ultrasound The child should have an ultrasound in six weeks' time The child should have a dimercaptosuccinic acid (DMSA) scan in six months' time The child should have a micturating cystourethrogram (MCUG) in six months' time There is no need for further tests at the moment

a : Th e c h ild sh ou ld h a ve a n im m edia t e u lt ra sou n d There is no need for an ultrasound as he had a typical UTI and made a quick recovery. b : Th e c h ild sh ou ld h a ve a n u lt ra sou n d in six week s' t im e There is no need for an ultrasound as he had a typical UTI and made a quick recovery. c : Th e c h ild sh ou ld h a ve a dim erc a pt osu c c in ic a c id (D MSA) sc a n in six m on t h s' t im e There is no need for a DMSA scan as he had a typical UTI and made a quick recovery. d : Th e c h ild sh ou ld h a ve a m ic t u ra t in g c yst ou ret h rogra m (MCUG) in six m on t h s' t im e There is no need for an MCUG as he had a typical UTI and made a quick recovery.

e : Th ere is n o n eed for fu rt h er t est s a t t h e m om en t According to NICE guidelines, there is no need for further tests at the moment.
T ab le 5 : T e s t s fo r ch ild r e n 3 y e ar s o r o ld e r Test Ultrasound during the acute infection Ultrasound within six weeks DMSA scan four to six months following the acute infection MCUG Re s p o n d s we ll t o t r e at me n t wit h in 4 8 h o u r s No No No No At y p ical UT I a Yes b c No No No Re cu r r e n t UT I a No Yes b Yes No

a See the learning bite box for denition. b Ultrasound in toilet trained children should be performed with a full bladder and with an estimate of bladder volume before and after micturition. c In a child with a non-E coli UTI, who is responding well to antibiotics and with no other features of atypical infection, the ultrasound can be requested on a non-urgent basis to take place within six weeks.

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