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[Infection of the urinary tract, its association with local predisposing factors]
Abstract:
A total of 167 cases of children with the diagnosis of urinary infection seen through the last five at the Hospital Infantil de México were studied with the purpose of investigating the frequency of the association of obstructive urologic malformations or vesicoureteral reflux with urinary infection and their role in the infection. Out of this number, there were 127 cases with urologic malformations, especially of the upper urinary tract. The most frequent symptoms were enuresis, lumbar pain and hematuria. Out of this group, 53 patients (41%) showed recurrent infections in contrast with only 4 out of 40 cases (10%) without malformation. Out of 167 cases, 64 recovered: 30 of the total of 40 who showed no malformations and only 34 out of 127 with malformations. Twelve cases in this group showed chronic renal insuficiency as final outcome, but none of the patients without malformation followed this course. Analysis of this clinical material shows a high incidence of urologic malformations in patients complaining of urinary infection which has an important role in mortality and lethality of this process. Thus, it is concluded that obstructive uropathy must be investigated in every case of urinary infection, especially if enuresis, lumbar pain or hematuria are present.
Insights
Urinary infections in children are frequently linked to urologic malformations, particularly in the upper urinary tract. Early investigation of obstructive uropathy is crucial for better outcomes.
Area of Science:
- Pediatric Nephrology
- Urology
- Infectious Diseases
Context:
- Urinary tract infections (UTIs) are common in children.
- The association between UTIs and congenital urologic anomalies requires further investigation.
- Understanding the role of malformations in UTI recurrence and severity is critical.
Purpose:
- To investigate the frequency of obstructive urologic malformations and vesicoureteral reflux in children with UTIs.
- To determine the role of these malformations in the pathogenesis and outcomes of pediatric UTIs.
Summary:
- A study of 167 children with UTIs revealed 127 cases (76%) had urologic malformations, primarily affecting the upper urinary tract.
- Children with malformations experienced significantly higher rates of recurrent UTIs (41% vs. 10%) and poorer recovery rates (26% vs. 75%).
- Chronic renal insufficiency developed in 12 cases, all of whom had urologic malformations.
Impact:
- The findings highlight a high incidence of urologic malformations in children with UTIs.
- Urologic malformations play a significant role in the morbidity and mortality associated with pediatric UTIs.
- Routine investigation for obstructive uropathy is recommended in all pediatric UTI cases, especially with symptoms like enuresis, lumbar pain, or hematuria.