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How can recurrent urinary tract infection be treated?

Q: My 7 years old daughter has recurring urinary tract infection (UTI). She has been on medication and takes antibiotics whenever she had fever. She also has reflux grade II and dimercaptosuccinic acid (DMSA) tests result showed scars on the left kidney and function is 22%, whereas right kidney is normal and function is 78%. In some urine routine tests results showed presence of white blood cells – 2 to 4 but culture reports showed growth of E. coli - 100000. What does that mean?

A:Recurrent UTI in a female child may indicate presence of urinary reflux from the bladder back into kidneys while passing urine, called vesico-ureteric reflux or VUR. This may have a deleterious defect on the kidney causing scars and functional deterioration. DMSA scan of your daughter suggests the presence of such reflux. She needs a micturating cystogram to confirm the same. Although further damage to kidney usually does not occur after the age of 7 or 8 years, but continuing reflux is a risk during pregnancies even during reproductive age group and hence may need treatment.

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