Box 3.

Features of high-risk children that warrant investigation for an abnormal urinary tract.

•Recurrent infections •Clinical signs, including poor urinary stream or palpable kidneys •Unusual organisms (those which are not Escherichia coli) •Urinary tract infection associated with bacteremia or septicemia •Prolonged clinical course, with failure to respond fully to antibiotic treatment within 48–72 h •Unusual clinical presentation, such as in an older boy •Known dilatation or abnormality on antenatal ultrasound screening of the urinary tract