Le infezioni febbrili delle vie urinarie

Translated title of the contribution: Febrile urinary tract infections

Giovanni Montini, Anita Ammenti, Luigi Cataldi, Roberto Chimenz, Vassilios Fanos, Angela La Manna, Giuseppina Marra, Marco Materassi, Paolo Pecile, Marco Pennesi, Lorena Pisanello, Felice Sica, Antonella Toffolo

Research output: Contribution to journalArticle

Abstract

We present the recommendations, prepared by a working group of the Italian Society of Pediatric Nephrology, for the diagnosis, treatment, imaging protocol and use of antibiotic prophylaxis in children having their first febrile urinary tract infection (UTI) between 2 months and 3 years of age. We also review the evidence from the literature on the long term medical consequences of post-infectious scars, as the aggressiveness of the diagnostic protocol depends on the severity of the consequences and the possibility to prevent them. Studies show very heterogeneous results regarding the population studied, the diagnostic criteria used for the diagnosis of UTI and the evaluation of outcomes (hypertension, renal damage). It appears that cohorts were selected on the basis of the presence of high grade reflux or dysplastic kidneys and a relation between UTI and general morbidities appears ambiguous and not measurable. Diagnosis of febrile UTIs is based on the clinical suspicion and appropriate urine sample collection (mid-stream urine or catheterization). An exclusive oral treatment is a reasonable option to treat a first febrile UTI. Antibiotic prophylaxis is not recommended in children with vesico-ureteric reflux grade I-II to prevent further UTIs; for severe refluxes (grade III to V), no definite evidence is available. We propose to perform a renal ultrasound in all children and an aggressive imaging protocol (micturating cystogram and renal DMSA scan) only in a group of high risk children selected on the basis of anamnestic, clinical and echographic data.

Translated title of the contributionFebrile urinary tract infections
Original languageItalian
Pages (from-to)359-370
Number of pages12
JournalMedico e Bambino
Volume28
Issue number6
Publication statusPublished - Jun 2009

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Montini, G., Ammenti, A., Cataldi, L., Chimenz, R., Fanos, V., La Manna, A., Marra, G., Materassi, M., Pecile, P., Pennesi, M., Pisanello, L., Sica, F., & Toffolo, A. (2009). Le infezioni febbrili delle vie urinarie. Medico e Bambino, 28(6), 359-370.