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Urinary tract infection in boys
Insights
Urinary tract infections (UTIs) in boys often present with fever and atypical bacteria. Most boys with UTIs have anatomical abnormalities, necessitating prompt evaluation with imaging studies.
Area of Science:
- Pediatric Urology
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common in children, but specific data on boys are limited.
- Boys with UTIs may experience higher morbidity compared to girls.
Purpose of the Study:
- To analyze the clinical presentation, causative organisms, anatomical abnormalities, and outcomes of urinary tract infections in boys.
- To establish optimal diagnostic and management guidelines for boys with UTIs.
Main Methods:
- Retrospective review of 83 boys diagnosed with an initial urinary tract infection.
- Analysis of presenting symptoms, microbial findings, anatomical evaluations, and treatment interventions.
Main Results:
- Fever was the most common symptom (50%). Gram-positive bacteria were most frequent, with Escherichia coli accounting for only 21%.
- 75% of boys had anatomical abnormalities, including vesicoureteral reflux and obstructive lesions. Renal scarring occurred in 50%, and 58% required early surgery.
- Atypical organisms were common, suggesting a different infectious profile in boys.
Conclusions:
- Urinary tract infections in boys are associated with significant anatomical abnormalities and potential for high morbidity.
- An excretory urogram and voiding cystourethrogram are recommended as minimal evaluations for boys after an initial UTI.
Abstract:
Considerable literature exists regarding the evaluation and treatment of children with urinary tract infection yet little has been reported solely about boys. We reviewed retrospectively 83 boys who were seen after an initial urinary tract infection. Fever was the most common presenting sign (50 per cent) and the most common organisms encountered were of the gram-positive group of bacteria. Escherichia coli accounted for only 21 per cent of the infections. Of the boys 75 per cent (62 patients) had an anatomic abnormality, most commonly vesicoureteral reflux, although more than 25 per cent of our patients had obstructive lesions. Renal scarring was present in half and 58 per cent required early surgical intervention. Urinary tract infection seems to have a higher morbidity in boys and the finding of an atypical organism is to be expected. Based on our findings, we strongly recommend an excretory urogram and a voiding cystourethrogram as the minimal evaluation of boys following an initial urinary tract infection.