Studies in urinary tract infection in childhood
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In 436 children in whom urinary Infection was suspected, bladder aspiration confirmed the diagnosis in 143 (26 male, 117 female). In a further 23 (3 male, 20 female; children, diagnosis was based on the demonstration of repeated significant bacteriuria and pyuria in midstream specimens of urine. Thus of the 43& patients who presented with suspected urinary infection, only 172 (40$) had proven infection. Of those patients (436) presenting with suspected urinary infection, only 24$ under the age of 2§• years and only 50$ over the age of 2j years had proven infection. In the 172 children with urinary infection, there was a preponderance of females at all ages giving a sex difference between females and ma3.es of 4:1 • One hundred and eleven (78$) of the 143 cases with urinary infection proven on suprapubic aspiration had a white cell count of more than 4 per cu.mm. in the bladder urine. In 106 children (42 male, 64 female) the urine obtained by bladder aspiration was sterile and in all but one of these cases the white cell count in the bladder urine was 4 or less per cu.mm. the clinical features of the 172 children with urinary infection at the time of presentation and of those with further recurrences during the course of follow up indicated that the symptoms of urinary infection under the age of 2^ years were non-specific i.e. fever, vomiting, diarrhoea, irritability, anorexia or feeding problem. In children over 2-£ years, the main symptoms were dysuria, frequency of micturition, fever and abdominal pain. Enuresis was the main symptom in children with recurrent urinary tract infection.