Urinary tract infection and other pediatric considerations

Urinary tract infection in childhood can lead to chronic sequelae, particularly in the presence of vesico-ureteric reflux or obstruction. The renal complications of acute pyelonephritis or residual chronic renal cortical scarring are most accurately evaluated with scintigraphy using Tc-99m dimercaptosuccinic acid. The diagnosis of renal obstruction can be problematic, particularly in infants and children. Diuresis renography is an established tool in diagnosing and assessing the severity of obstruction. However the methodology for performing diuresis renography is a very controversial area in paediatric nuclear medicine, due to the lack of a gold standard. The surgical management of neonatal hydronephrosis is similarly controversial.