The prognostic significance of fever in childhood urinary infections: observations in 350 consecutive patients.

All infants and children with proven bacteriuria require urologic investigation and surveillance, but their prospects for developing chronic renal disease are variable. These differences are related to whether or not the bacteria have access to the kidneys. Such access correlates closely with the presence of an underlying congenital anomaly, particularly vesicoureteral reflux. Fever during an episode of active urinary infection is a strong indication that the patient has vesicoureteral reflux or some other significant uropathy and probably pyelonephritis.