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Recommended imaging schedule for infants and children 6 months or older but younger than 3 years

Authoring team

Test

Responds well to treatment within 48 hours

Atypical UTI*

Recurrent UTI*

Ultrasound during the acute infection

No

Yes***

No

Ultrasound within 6 weeks

No

No

Yes

DMSA 4-6 months following the acute infection

No

Yes

Yes

MCUG

No

No**

No**

*

  • atypical UTI includes:
    • seriously ill
    • poor urine flow
    • abdominal or bladder mass
    • raised creatinine
    • septicaemia
    • failure to respond to treatment with suitable antibiotics within 48 hours
    • infection with non-E. coli organisms
  • recurrent UTI:
    • two or more episodes of UTI with acute pyelonephritis/upper urinary tract infection, or
    • one episode of UTI with acute pyelonephritis/upper urinary tract infection plus one or more episode of UTI with cystitis/lower urinary tract infection, or
    • three or more episodes of UTI with cystitis/lower urinary tract infection

**

while MCUG should not be performed routinely it should be considered if the following features are present:

  • dilatation on ultrasound
  • poor urine flow
  • non-E. coli-infection
  • family history of VUR

***

in an infant or child with a non-E. coli-UTI, 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 6 weeks

Reference

  1. NICE. Urinary tract infection in under 16s: diagnosis and management. NICE guideline NG224. Published July 2022

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