Urosepsis bei Kindern und Jugendlichen – konservative und operative Therapie

Abstract

Urinary tract infections (UTI) are the most common infectious diseases in children. Urosepsis in childhood, though rare, is the most complicated possible variant. In newborns and infants, unspecific symptoms are a significant barrier to a fast and reliable diagnosis, which is crucial to successful treatment. In addition to urine and laboratory tests as well as non-invasive examinations (ultrasound), there may be an indication for invasive examinations of the kidneys (DMSA scans) in cases of a severe infection. Conservative therapy consists of targeted parenteral antibiotic treatment and paediatric sepsis management. Surgical desobstruction and urinary diversion are indicated if conservative therapy has failed. In addition to catheterised drainage of the upper and lower urinary tract, open surgery techniques are used in due consideration of the child and situation. Also, causal factors such as congenital malformations of the urinary system leading to impaired urinary drainage (vesicoureteral reflux, obstruction) have to be evaluated and treated.