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Urinary tract infection in children.
Summary
Fever is a common sign of urinary tract infections (UTI) in young children, often with low nitrite test results. Extended fever and high C-reactive protein levels predict pyelonephritis risk in pediatric UTI patients.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Medical Imaging
Background:
- Urinary tract infections (UTIs) are common in children, particularly those under two years old.
- Fever is the predominant symptom, especially in younger pediatric populations.
- Diagnostic challenges include low positive rates for nitrite tests in UTIs.
Purpose of the Study:
- To analyze clinical presentations, laboratory data, and imaging findings in pediatric UTI patients.
- To determine the prevalence of vesicoureteric reflux and pyelonephritis in children with UTI.
- To identify risk factors for pyelonephritis in pediatric UTI cases.
Main Methods:
- Retrospective analysis of 285 children under 15 with confirmed UTIs.
- Evaluation of clinical signs, dipstick urinalysis, and laboratory inflammatory markers (C-reactive protein).
- Imaging studies included voiding cystourethrography (VCUG) and 99mTc-dimercaptosuccinic acid (DMSA) renal scans; renal ultrasonography was also assessed.
Main Results:
- Escherichia coli was the most frequent pathogen, exhibiting high resistance to ampicillin (90.2%) and trimethoprim/sulfamethoxazole (57.1%).
- VCUG revealed vesicoureteric reflux in 24.6% of cases; DMSA scans showed pyelonephritis in 63.3%.
- Longer fever duration and elevated C-reactive protein levels correlated with increased risk of pyelonephritis and vesicoureteric reflux.
Conclusions:
- Fever is a key indicator in pediatric UTIs, despite low nitrite test positivity.
- Pyelonephritis in children is not exclusively linked to vesicoureteric reflux.
- Prolonged fever and high C-reactive protein are valuable predictors for identifying pyelonephritis risk in pediatric UTI patients.