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[Febrile Urinary Tract Infections: When are they an Emergency?]
1Abteilung Urologie, Zentralkrankenhaus Bozen.
Insights
Urinary tract infections (UTIs) in infants require prompt suspicion due to subtle symptoms. Early diagnosis and intervention are crucial to prevent severe complications in febrile infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Urinary tract infections (UTIs) are common in febrile infants.
- Diagnosing UTIs in infants is challenging due to their inability to communicate symptoms.
- Subtle onset of infection can lead to rapid deterioration and emergency situations.
Purpose of the Study:
- To highlight the importance of suspecting urinary tract infections (UTIs) in all febrile infants.
- To emphasize the diagnostic challenges in infants compared to older children.
- To underscore the potential for rapid progression to severe disease in undiagnosed cases.
Main Methods:
- Clinical observation and case review of febrile infants.
- Comparison of UTI presentation in infants versus older children and adolescents.
- Review of management strategies for complicated UTIs in pediatric populations.
Main Results:
- Febrile infants warrant a high index of suspicion for urinary tract infections (UTIs).
- Classical UTI symptoms are often absent in infants, complicating diagnosis.
- Delayed diagnosis in infants can result in severe illness and necessitate urgent intervention.
Conclusions:
- Urinary tract infections (UTIs) must be considered in every febrile infant.
- Prompt diagnosis and management are critical to prevent severe outcomes.
- In cases of obstruction, urinary tract drainage may be required for effective treatment.
Abstract:
Urinary tract infections should be suspected in every febrile infant until proven otherwise. While older children and adolescents mostly present with classical features such as dysuria, flank pain and/or abdominal pain, secondary enuresis or pollakiuria, diagnosing infants or newborns, who are incapable of describing or pinpointing pain, can be much more challenging. As such, an infection with gradual and subtle onset may result in fulminant disease and emergency situations. In children with urinary tract infections and known mechanical or functional obstructions of the urinary tract, adequate drainage of the infected urinary tract may be necessary (e. g. nephrostomy, ureteral stent or transurethral catheter).
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