Abnormal Ultrasound Findings After a Urinary Tract Infection in Children

Area of Science:

• Pediatric Nephrology
• Diagnostic Imaging
• Infectious Diseases

Background:

• Urinary tract infections (UTIs) are common in children.
• Ultrasound screening is often used to detect urinary tract abnormalities (UTAs) after a UTI.
• Current guidelines often recommend screening only for children under two years old.

Purpose of the Study:

• To determine the occurrence of UTAs detected via ultrasound in children after a UTI, irrespective of age.
• To evaluate the effectiveness of age-based screening recommendations.

Main Methods:

• A cohort study of 2050 children (0-16 years) who underwent urinary tract ultrasound after a UTI between 2004 and 2015.
• Exclusion of children with pre-existing urinary tract pathologies.
• Analysis of ultrasound findings in relation to age, gender, and UTI characteristics.

Main Results:

• Overall, 5.7% of children had abnormal ultrasounds.
• In children with pyelonephritis, 70% of abnormal ultrasounds were in those younger than two years.
• Age under two was not significantly associated with an increased risk of abnormality (OR 0.99).
• Boys, non-E. coli UTIs, and recurrent UTIs were associated with a higher risk of UTAs.

Conclusions:

• Limiting ultrasound screening after pyelonephritis to children under two years may miss a substantial proportion (30%) of UTAs.
• Current age-based screening guidelines may be insufficient.
• Consideration of other risk factors like gender and UTI type is warranted for comprehensive screening.