Symptomatic urinary infection in childhood: presentation during a four-year study in general practice and significance and outcome at seven years.

Thirty-eight children (12 boys and 26 girls) with symptomatic urinary infection have been studied in general practice. Patients were collected over a four-year period and we report an incidence of urinary infection according to Kass's criterion of 7.7 per 1,000 girls at risk per year and 3.8 per 1,000 boys at risk per year. Eighty-four per cent of the children had symptoms which suggested an origin in the genitourinary tract. Proteus infection was found in five of the boys and only one of the girls. At the end of the four-year study period follow-up had taken place over a mean period of 25 months and recurrent infection had been demonstrated in four boys and 12 girls. All the children had an excretion urogram and two children, both girls, were found to have pyelonephritic scarring. Twelve children with recurrent infection were investigated for vesicoureteric reflux, which was found only in the two children with scarring. At seven years 31 of the children remained in the practice and, with a mean follow-up of 42 months, no significant alteration in the figures for recurrent infection was demonstrated. Guidelines are suggested for the management of childhood urinary infection in general practice.