Urinary tract infections (UTIs) are an important cause of febrile illnesses in infants and children in the United States. UTI occurs in 4 to 7 percent of febrile infants. 1 Symptomatic UTIs occur in approximately 2 percent of children from 1 to 5 years of age and in up to 3 to 5 percent of school-aged girls. 2 Since the presenting signs and symptoms are often nonspecific, especially in younger infants, the diagnosis of UTI is often presumptive rather than definitive. The incidence of UTI varies greatly with age, gender, historical factors, such as prematurity, and history of previous UTI. Proper initial evaluation, interpretation of laboratory data, treatment, and follow-up are essential to avoid the long- term complications of renal scarring. The American Academy of Pediatrics has published a practice parameter on this subject, the recommendations from which are reflected in this chapter.3
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