Early neonatal urinary tract infection: a case report and review

We report the earliest case of urinary tract infection (UTI) so far described in term uncomplicated newborn infants. The unusual features of this case included early massive hematuria as the only presenting symptom and a host with no risk factors for either sepsis or localization of infection in the genitourinary tract. Reports of urinary analysis, urine cultures, renal ultrasound, and renal scan established the diagnosis of UTI. Massive hematuria in this case was probably precipitated by mild renal venous thrombosis. Ampicillin-resistant Escherichia coli was cultured from the urine, which responded promptly to appropriate treatment. A urine culture was done because of the predominantly urinary signs and symptoms. Although urine culture analysis is not routinely performed for the evaluation of possible sepsis before 72 hours of age, this investigation may be important in critically ill neonates who present with predominantly genitourinary signs and symptoms.