Managing children under 36 months of age with febrile urinary tract infection: A new approach

Marco Pennesi, Ines L'Erario, Laura Travan, Alessandro Ventura

Research output: Contribution to journalArticlepeer-review

Abstract

Background Recent guidelines on urinary tract infection (UTI) agree on reducing the number of invasive procedures. None of these has been validated by a long-term study. We describe our 11-years experience in the application of a diagnostic protocol that uses a reduced number of invasive procedures. Methods We reviewed retrospectively the records of 406 children aged between 1 and 36 months at their first UTI. All patients underwent renal ultrasound (RUS). Children with abnormal RUS and those with UTI recurrences underwent voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) renal scans. Results RUS after the first UTI was pathological in 7.4% children; 4.4 % had a second UTI.We performed 48 VCUG: 14 patients (29%) had vesicoureteral reflux (VUR), 12 of which showed an abnormal RUS while 2 had recurrent UTI. After DMSA renal scan renal damage appeared in only 6 of them (12.5%); all these children showed grade IV VUR. Conclusions The application of our guidelines leads to a decrease in invasive examinations without missing any useful diagnoses or compromising the child's health.

Original languageEnglish
Pages (from-to)611-615
Number of pages5
JournalPediatric Nephrology
Volume27
Issue number4
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Antibiotic prophylaxis
  • Renal scars
  • Urinary tract infection
  • Vesicoureteral reflux

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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