THE NATURAL HISTORY OF BACTERIURIA IN CHILDHOOD

摘要: The identification of bacteria 1 century ago soon led to the finding microorganisms in urine and description children with urinary tract infection (UTI). An early report by Goppert described different clinical presentations pointed out that it is a common disease endemic character. 5 He also mortality rate 20% infants small febrile UTI. Effective therapy was not available until introduction sulfonamides during 1930s, but since then further development antibiotics an increased awareness high frequency UTI together improved diagnostic methods have decreased acute close zero industrialized countries. Urinary term used for mixture diseases causes growth within common. There great variation presentation. In some individuals, bacteriuria no symptoms only screening healthy can reveal its existence. Symptoms vary from foul smelling urine, dysuria, loin pain peaking fever signs circulatory shock. Many one episode UTI; others repeated infections. Some develop permanent renal damage potentially lead hypertension, pregnancy complications, even failure. It complex pattern dominated benign episodes large proportion serious infections; these need be diagnosed, treated, investigated, followed-up on. Our knowledge natural history childhood still incomplete. are several reasons this. Most managed at primary care level, each practitioner handling restricted number children. therefore difficult create population-based registries necessary epidemiologic studies. Furthermore, course often runs over decades, follow patients such long periods time difficult. Finally, there continuous change management influences hopefully improves long-term prognosis which make comparisons between example this switch urography dimercaptosuccinic acid (DMSA) scanning study going on many centers. 4 During first half 1960s, Jan Winberg et al performed pioneering studies Goteborg. They introduced standardized protocol diagnosis, treatment, investigation, follow-up encouraged doctors refer suspected Children's Hospital. A special clinic created provide instrument efficient manage whenever recurrence suspected. cooperation evolved, especially departments pediatric radiology microbiology important papers were published. 34,35 Goteborg Childhood Research Group has been continuously functioning 1960 uses basically same protocol, although focus interest members changed years. This article describes local organization Further, gives selected aspects focusing results authors' group.