Urinary-tract infection (UTI) is one of the most common infectious diseases in children; however, the significance of combined infection in the pathogenesis of UTI remains uncertain. Of 48,382 patients discharged from Texas Children's Hospital from July 1, 1991, to June 30, 1994, 1,221 (2.5%) were discharged with a diagnosis of UTI. We retrospectively reviewed the files of these 1,221 patients to assess for concomitant infections and causative microorganisms in patients with first-time UTI, no urologic abnormalities, and no other major diagnoses. Of the 1,221 patients, 511 (42%) had first-time UTI with no urological abnormalities or other major diagnoses, of which 449 (87.8%) had UTI only, and 62 (12.1%) had concomitant infectious diseases. The 62 patients with concomitant infections comprised the study group for our series. There were 38 boys and 24 girls with a mean age of 2.9 years. Most of the patients (42/62) were younger than 1 year old. Eihteen patients had otitis media, 16 had acute pneumonia, 14 had acute bronchiolitis, 5 had acute gastroenteritis, 4 had meningitis, 2 had upper respiratory tract infection, 1 had eye infection, 1 had vaginitis, and 1 had vulvovaginitis and salpingo-oophoritis. E. coli was the most common pathogen, accounting for 34 (51.5%) of the organisms isolated in these patients, followed by Klebsiella, which accounted for 10 (15.2%) of the isolated organisms. We conclude that many patients diagnosed with UTI may have concomitant infectious diseases as well, particularly children younger than 1 year old who have nonspecific symptoms. Evaluation of UTI is particularly important in young children who experience frequent childhood infections.

Urinary-tract infection (UTI) is one of the most common infectious diseases in children; however, the significance of combined infection in the pathogenesis of UTI remains uncertain. Of 48,382 patients discharged from Texas Children's Hospital from July 1, 1991, to June 30, 1994, 1,221 (2.5%) were discharged with a diagnosis of UTI. We retrospectively reviewed the files of these 1,221 patients to assess for concomitant infections and causative microorganisms in patients with first-time UTI, no urologic abnormalities, and no other major diagnoses. Of the 1,221 patients, 511 (42%) had first-time UTI with no urological abnormalities or other major diagnoses, of which 449 (87.8%) had UTI only, and 62 (12.1%) had concomitant infectious diseases. The 62 patients with concomitant infections comprised the study group for our series. There were 38 boys and 24 girls with a mean age of 2.9 years. Most of the patients (42/62) were younger than 1 year old. Eihteen patients had otitis media, 16 had acute pneumonia, 14 had acute bronchiolitis, 5 had acute gastroenteritis, 4 had meningitis, 2 had upper respiratory tract infection, 1 had eye infection, 1 had vaginitis, and 1 had vulvovaginitis and salpingo-oophoritis. E. coli was the most common pathogen, accounting for 34 (51.5%) of the organisms isolated in these patients, followed by Klebsiella, which accounted for 10 (15.2%) of the isolated organisms. We conclude that many patients diagnosed with UTI may have concomitant infectious diseases as well, particularly children younger than 1 year old who have nonspecific symptoms. Evaluation of UTI is particularly important in young children who experience frequent childhood infections.