Ultrasound
You note from the NICE guideline that the timing of an ultrasound for an infant less than 6 months of age depends on whether their UTI is classified as “simple” or “atypical/recurrent”. Whilst this is Oli’s first UTI, you have an interesting discussion with the consultant over whether this should be classified as atypical or not. You conclude that Oli was not seriously unwell and agree that it would be safe to wait 6 weeks for the scan, although the consultant admits that you could also justify an earlier scan on the basis that Oli needed intravenous antibiotics for a systemic infection.
Image by Drahreg01 from Wikipedia, used under Creative Commons license
Dimercaptosuccinic acid (DMSA) scan
A nuclear medicine study. This test takes advantage of the filtration function of the kidneys to help identify areas that are not functioning correctly. It will show the size, shape and position of the kidneys and demonstrate areas of scarring or abnormal development.
Micturating Cystourethrogram (MCUG)
This is an invasive test as it requires the child to be catheterised and then a radio-opaque dye is passed into the child's bladder. The movement of this dye as the child passes urine (micturates) can then be seen. It can be a useful way to demonstrate reflux from bladder towards the kidneys (vesicoureteric reflux) or bladder outflow tract obstruction.
