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[Pyelonephritis in children--a retrospective study]
Insights
Urinary tract infections (UTIs) in children are frequently linked to urological abnormalities, particularly in boys during their first year. Improved urine sample collection and long-term complication monitoring are recommended.
Area of Science:
- Pediatric infectious diseases
- Urology
- Nephrology
Context:
- Urinary tract infection (UTI) is a prevalent childhood bacterial infection.
- UTIs can be associated with congenital urological malformations.
- Severe UTIs may lead to permanent kidney damage.
Purpose:
- To analyze the characteristics of children with first-time UTI admitted to Ullevål Hospital between 1988-1997.
- To evaluate patient demographics, symptoms, diagnostic methods, and identified abnormalities.
- To identify potential areas for improving diagnostic and management protocols.
Summary:
- A retrospective study included 180 children with first-time UTI.
- Boys constituted 38% of cases, with 87% referred in their first year.
- Over half of the children had urological abnormalities, most commonly vesicoureteric reflux; fever was the sole symptom in only 16%.
- Urine sampling methods were suboptimal in many cases.
Impact:
- Highlights a high prevalence of urological malformations in pediatric UTI cases.
- Underscores the need for enhanced urine sampling techniques.
- Emphasizes the importance of evaluating long-term complications in children with UTI.
Background:
Urinary tract infection (UTI) is a common bacterial infection in childhood, sometimes associated with urological malformations and, in a few cases, causing permanent renal damage.
Material And Methods:
A retrospective study was performed of children with UTI first time admitted to Ullevål Hospital during the period 1988-97. All medical records with diagnoses related to the urinary tract were investigated. Criteria for inclusion were bacteriuria and temperature > or = 38.5 degrees C in children over one year of age, and bacteriuria below one year of age.
Results:
Age, sex, symptoms, urine sampling method, medical treatment and radiological investigations were evaluated. 180 children were included, (38% boys, 62% girls), 87% of the boys were referred during this first year of life. Fever as sole symptom was found in one of six. Urinary tract related symptoms were rare. Urine sampling was performed by suprapubic aspiration in only 7%, and was not specified in half of the samples. Imaging evaluation was performed in almost all children. More than half of the evaluated children had one or more abnormalities, vesicoureteric reflux being the most frequent.
Interpretation:
In our material we find a high frequency of urological malformations. Better routines for urine sampling and evaluation of long term complications are suggested.