Pediatric febrile urinary tract infections

The current state of play

Ian K. Hewitt, Giovanni Montini

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Studies undertaken in recent years have improved our understanding regarding the consequences and management of febrile urinary tract infections (UTIs), which are amongst the most common serious bacterial infections in childhood, with renal scarring a frequent outcome. In the past pyelonephritic scarring of the kidney, often associated with vesico-ureteral reflux (reflux nephropathy) was considered a frequent cause of chronic renal insufficiency in children. Increasing recognition as a consequence of improved antenatal ultrasound, that the majority of these children had congenital renal hypo-dysplasia, has resulted in a number of studies examining treatment strategies and outcomes following UTI. In recent years there is a developing consensus regarding the need for a less aggressive therapeutic approach with oral as opposed to intravenous antibiotics, and less invasive investigations, cystourethrography in particular, following an uncomplicated first febrile UTI. There does remain a concern that with this newer approach we may be missing a small subgroup of children more prone to develop severe kidney damage as a consequence of pyelonephritis, and in whom some form of intervention may prove beneficial. These concerns have meant that development of a universally accepted diagnostic protocol remains elusive.

Original languageEnglish
Article number57
JournalItalian Journal of Pediatrics
Volume37
Issue number1
DOIs
Publication statusPublished - 2011

Fingerprint

Urinary Tract Infections
Fever
Pediatrics
Kidney
Cicatrix
Vesico-Ureteral Reflux
Pyelonephritis
Chronic Renal Insufficiency
Bacterial Infections
Anti-Bacterial Agents
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Pediatric febrile urinary tract infections : The current state of play. / Hewitt, Ian K.; Montini, Giovanni.

In: Italian Journal of Pediatrics, Vol. 37, No. 1, 57, 2011.

Research output: Contribution to journalArticle

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