One in six children with initial urinary tract infection will have renal scarring on follow-up

2011 ◽  
Vol 159 (1) ◽  
pp. 164 ◽  
Author(s):  
Ellen Wald
Author(s):  
Lotem Goldberg ◽  
Yael Borovitz ◽  
Nir Sokolover ◽  
Asaf Lebel ◽  
Miriam Davidovits

1979 ◽  
Vol 1 (5) ◽  
pp. 133-136
Author(s):  
Richard H. Rapkin

The identification of urinary tract infection (UTI) is important in order to reduce its morbidity, to prevent its sequelae, and to identify underlying disease. This article will discuss methods of diagnosis and management of UTI, screening for UTI, and the importance of further evaluation and follow-up of children with UTIs. Much of what we know about UTI is controversial and rapid generation of new knowledge may make current recommendations passé. CASE V.M., a 4-year-old girl, was brought to the physician's office with the chief complaint of frequency of urination. Nine months before she had been seen because of frequency and dysuria and two consecutive midstream urine cultures grew >100,000 colonies/ml of a Gramneative rod. Sulfisoxazole was begun and a urine culture was sterile 48 hours after therapy was begun. The dysuria and frequency disappeared; therapy was continued for ten days and a urine culture four days later was sterile. One week later a voiding cystourethrogram (VCU) and an intravenous pyelogram (IVP) were performed and were interpreted as normal. Repeat urine cultures at one, two, three, and six months after the episode were sterile. Two days before the child was seen, she had become irritable and wet the bed during sleep (she had been successfully trained at 27 months of age), and she began to void frequently during the next 24 hours.


2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
Author(s):  
Ana Bispo ◽  
Milene Fernandes ◽  
Cristina Toscano ◽  
Teresa Marques ◽  
Domingos Machado ◽  
...  

<strong>Introduction:</strong> Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.<br /><strong>Material and Methods:</strong> This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.<br /><strong>Results:</strong> A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p &lt; 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p &lt; 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the<br />most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.<br /><strong>Discussion:</strong> Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.<br /><strong>Conclusion:</strong> Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.<br /><strong>Keywords:</strong> Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.


PEDIATRICS ◽  
2015 ◽  
Vol 136 (1) ◽  
pp. e13-e21 ◽  
Author(s):  
R. Keren ◽  
N. Shaikh ◽  
H. Pohl ◽  
L. Gravens-Mueller ◽  
A. Ivanova ◽  
...  

2020 ◽  
Vol 9 (8) ◽  
pp. 4292
Author(s):  
Manisha Bisht ◽  
PreetinderSingh Manshahia ◽  
Ankur Mittal ◽  
Mohit Bhatia ◽  
ShailendraS Handu

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Kashyap Narsingh Shakya ◽  
UMS Dangol ◽  
SB Khadka

Pain abdomen is a common pediatric complaint that brings patient to the hospital in Nepal.Knowledge about its etiology and frequency helps in its evaluation and management. The presentstudy was undertaken to find out the causes and their frequency of pain abdomen in Nepalichildren. Children with pain abdomen presenting at the emergency room and pediatric outpatientdepartment of Kathmandu Medical College, Kathmandu from January, 2006 to December 2007 wereclinically evaluated and investigated to find out the causes and frequency of their pain abdomen. Theoutcomes were tabulated and analyzed for interpretation. Of 444 patients attended, 356 completedinvestigations and came for follow up. Cause of pain abdomen was apparent in 117 (32.9%) only.91.5% were medical causes, comprising predominantly of diarrheal diseases (28.3%), infantile colic(9.4%), urinary tract infection (7.7%) and acid peptic disease (6.8%). 8.5% causes were related tosurgical conditions, which needed operative management. Secondary or extra-abdominal causeswere found in 20 cases (17.1%). Pneumonia (2), functional (5), vulvovaginitis (2) and infantile colic(11) were predominant causes. Our study showed that the causes of pain abdomen in children werepredominantly medical. Gastroenteritis was the most frequent cause. Secondary causes, includingfunctional and emotional causes were infrequent. Small percentage needing surgical managementformed a diagnostic challenge.Key words: abdomen, children, gastroenteritis, pain


Author(s):  
Samuel Uwaezuoke ◽  
Adaeze Ayuk ◽  
Uzoamaka Muoneke

Urinary tract infection (UTI) is a significant cause of morbidity in children. Delayed treatment is associated with complications that may result in chronic kidney disease and, subsequently, end-stage kidney disease. Over the years, clinical practice guidelines have advanced to ensure the best global practices in treating the infection and preventing its progression to chronic kidney disease. The established practice guidelines address five main questions: 1) which children should have their urine tested; 2) how the sample should be obtained; 3) which radiological tests are recommended after a diagnosis of UTI; 4) how the infection should be treated; 5) and how affected children should be followed up. There is a substantial overlap in the recommendations of the American Academy of Pediatrics (AAP) guidelines and the UK’s National Institute for Health and Clinical Excellence (NICE) guidelines. Subtle differences, however, exist between the two established guidelines. An evidence-based paradigm shift of some traditional concepts about UTI in children has contributed to the revision and update of these guidelines. Further research is needed to clarify the role of host and genetic factors in renal scarring, as well as the diagnostic criteria for UTI. This narrative review aims to discuss the current recommendations of these established practice guidelines with an emphasis on the diagnosis, radiological investigation, treatment, and follow-up of UTI in children.


2017 ◽  
Vol 56 (03) ◽  
pp. 109-114 ◽  
Author(s):  
Jeong Won Lee ◽  
Joon Soo Park ◽  
Kyeong Bae Park ◽  
Gyeong Hee Yoo ◽  
Seung Soo Kim ◽  
...  

SummaryAim: This study is aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for cortical defect on initial and follow-up Tc-99m dimercaptosuccinic acid (DMSA) scan in children with the first febrile urinary tract infection (UTI). Methods: We retrospectively enrolled 179 children with the first febrile UTI who underwent DMSA scan and laboratory tests. In patients with abnormal DMSA scan findings, follow-up DMSA scan was performed at least 6 months after the initial scan. All DMSA scans were classified as negative and positive cortical defects. Multiple logistic regression analyses were performed to identify the risk factors for cortical defect on initial and follow-up DMSA scan. Results: Cortical defects on initial DMSA scan were noted in 133 patients. Vesicoureteral reflux (VUR), white blood cell count, absolute neutrophil count, NLR, and serum C-reactive protein level were independent predictive factors for positive cortical defect on initial DMSA scan (p < 0.050). On follow-up DMSA scan, 24 of the 133 patients showed persistent cortical defects, and only VUR was significantly associated with persistent cortical defect (p = 0.002). In 84 patients who showed cortical defect on initial scan and absence of VUR, only NLR was significantly associated with persistent cortical defect on follow-up scan (p = 0.025). Conclusion: NLR was significantly associated with persistent cortical defect on follow-up DMSA scan in patients without VUR, as well as positive cortical defect on initial scan.


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