[Urinary tract infections in childhood (author's transl)].

The clinical symptoms of urinary tract infections (UTI) are only rarely an indication of the presence of the disease in childhood. Of decisive importance for the detection of UTI is an appropriate investigation to determine whether there is significant bacteriuria. Since in a significant proportion of cases of UTI in children there is underlying congenital anomaly or functional change in the urinary tract with stasis, and since surgical means of treatment are available today, diagnosis, i.e. at least radiological exploration, is essential. Approximately half the children with UTI are younger than one year at the time of diagnosis. In neonates, boys are more frequently affected than girls, whereas in older age-groups the incidence of significant bacteriuria (approximately 1.5%) and clinically relevant UTI or pyelonephritis is higher in females than in males. "Idiopathic" ("non-urologically induced") UTI is very seldom found in boys after infancy, and "asymptomatic bacteriuria" is largely confined to females. The "urethral syndrome" is probably caused by minor obstruction of the urethra and "bladder-sphincter dyssynergy". The fact that approximately nine of ten cases of UTI relapse in children are due to reinfection with a different pathogen has certain consequences for therapy. Prophylactic long-term medication is recommended during the phase after surgical correction of anomalies of the urinary tract.