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Recurrent Febrile Urinary Tract Infections in a Five-Year-Old Girl

Hesham H AbdelAziz1, Mohamed H Gad2

  • 1Department of Urology, Al Soliman Hospital, Port Said, EGY.

Cureus
|May 14, 2021
PubMed

Insights

Recurrent febrile urinary tract infections (UTIs) in a child with spina bifida occulta were linked to detrusor sphincter dyssynergia. Early intervention is crucial to prevent complications from bladder outlet obstruction.

Area of Science:

  • Pediatric Urology
  • Neuro-urology

Background:

  • Urinary tract infections (UTIs) are common in children, but clinical presentation varies by age.
  • No specific features reliably indicate UTI in infants or children.
  • Spina bifida occulta can be associated with lower urinary tract dysfunction.

Observation:

  • A five-year-old female with spina bifida occulta presented with recurrent febrile UTIs.
  • Diagnosis of detrusor sphincter dyssynergia was made.
  • Urodynamic studies revealed an overactive uroflow pattern with bladder outlet obstruction (BOO), prolonged voiding time, and terminal dribbling.

Findings:

  • The patient demonstrated secondary detrusor overactivity secondary to bladder outlet obstruction.
  • A coincidental finding of spina bifida occulta was noted.
  • Urodynamic findings confirmed high flow obstruction.

Implications:

  • This case highlights a typical presentation of secondary detrusor overactivity in a pediatric patient with BOO and spina bifida occulta.
  • Early diagnosis and treatment of detrusor sphincter dyssynergia are vital.
  • Prompt intervention can reduce the risk of recurrent UTIs and long-term renal complications.

Keywords:
bladder outlet obstructiondetrusor external sphincter dyssynergiadetrusor overactivityoveractive bladderspina bifida occultaurinary tract infectionvesicoureteral reflux

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