Guignard J P
Schweiz Med Wochenschr. 1977 Nov 19;107(46):1671-5.
Urinary tract infection (UTI) is relatively frequent in children. The symptoms are often atypical; the more so, the younger the child. UTI is often associated with functional or malformative uropathy, such as vesico-ureteral reflux or obstruction. Radiological investigation should be carried out in every child presenting with his first UTI. The prognosis of uncomplicated UTI is good, but is less favorable when UTI is associated with urological abnormalities. Development of pyelonephritic lesions can lead to kidney scarring for which the occurrence of intrarenal reflux, associated with a specific type of papilla, is probably responsible. Short-term treatment is recommended for uncomplicated UTI. Uncomplicated UTI with frequent relapses, or UTI associated with vesio-ureteral reflux, requires prophylactic chemotherapy. Worsening of reflux and/or the development of pyelonephritic lesions while on prophylactic treatment are an indication for surgical intervention. Surgery is always indicated in the presence of a major urological malformation. Be it medical or surgical, treatment of UTI should always be followed by regular urine cultures for several years.
尿路感染（UTI）在儿童中较为常见。其症状往往不典型，患儿年龄越小越不典型。UTI常与功能性或畸形性泌尿系统疾病相关，如膀胱输尿管反流或梗阻。对于首次出现UTI的每个儿童都应进行影像学检查。单纯性UTI的预后良好，但当UTI与泌尿系统异常相关时预后较差。肾盂肾炎性病变的发展可导致肾瘢痕形成，肾内反流的发生可能与此有关，肾内反流与特定类型的乳头有关。推荐对单纯性UTI进行短期治疗。单纯性UTI频繁复发或UTI与膀胱输尿管反流相关，需要预防性化疗。预防性治疗期间反流加重和/或肾盂肾炎性病变的发展是手术干预的指征。存在重大泌尿系统畸形时总是需要手术治疗。无论是药物治疗还是手术治疗，UTI治疗后都应连续数年定期进行尿培养。
