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Urinary tract infections (UTI) (Paediatric Surgery)


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Child with known renal tract abnormalities
    • Significant neonatal renal pelvic dilatation (>15mm or >10mm if bilateral)
    • Concerns regarding obstruction

    The following conditions could be referred to general paediatrics or paediatric surgery depending on the service and underlying condition

    • Infants and children > 3 months with history of acute pyelonephritis/upper urinary tract infection
    • Infants ≤ 6 months presenting with 1st UTI (after acute episode)
  • Category 2
    (appointment within 90 calendar days)
    • Recurrent UTI with abnormal imaging results not category one
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Evaluate adequacy of urinary stream
  • MSU MCS results (clean catch)
    • infants and children presenting with unexplained fever of 38°C or higher should have a urine sample tested after 24 hours at the latest
  • Renal tract USS results
    • <1 year old first UTI
    • children of any age with recurrent UTI
    • children any age with an atypical UTI or UTI responding poorly to treatment

3. Additional referral information Useful for processing the referral

Highly desirable information – may change triage category

  • Frequency of urinary tract infections and age of first onset
  • A reliable urine specimen is vital to confirm the diagnosis – urine bags must not be used (high false positive rate)
  • Urinalysis (dipstick)

Desirable information- will assist at consultation

  • History of constipation, fluid intake, poor hygiene
  • Other past medical history
  • Immunisation history
  • Developmental history
  • Medication history
  • Significant psychosocial risk factors (esp. parents mental health, family violence, housing and financial stress, department of child safety involvement)
  • Height/weight/head circumference and growth charts with prior measurements if available.
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any relevant laboratory results or medical imaging reports (high false positive rate)

4. Request

Last updated: 13 June 2023