Influence of Febrile Urinary Tract Infection on Ultrasonic Measurements of Nonreflux Upper Urinary Tract Dilation in Infants

Abstract Background To investigate the changes in ultrasonic measurements of nonreflux upper urinary tract dilation in infants with febrile urinary tract infection (UTI).Methods There were 28 cases of nonreflux upper urinary tract dilatation with febrile UTI: 14 cases of ureteropelvic junction obstruction (UPJO) (14 kidneys) and 14 cases of ureterovesical junction obstruction (UVJO) (16 kidneys). Changes in anteroposterior renal pelvic diameter (APD) and ureteral dilatation during infection and after infection were compared in UPJO and UVJO patients, respectively.Results In the UPJO with febrile UTI group, the APD was 24.1±10.0 mm at the time of UTI and 16.6±7.0 mm 1 week after infection recovery (P<0.001). In the UVJO with febrile UTI group, the APD was 19.3±8.5 mm at the time of UTI and 15.2±7.7 mm 1 week after infection recovery (P<0.001). In the UVJO with febrile UTI group, the ureteric diameter was 11.0±3.2 mm during UTI and 6.8±2.6 mm 1 week after infection recovery (P<0.001).Conclusions In UPJO patients, the APD decreased after febrile UTI treatment compared with that during infection. In UVJO patients, the APD and ureteric diameter decreased after febrile UTI treatment compared with that during infection.

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Febrile Urinary Tract Infection after Radical Cystectomy with Urinary Diversion: Different Characteristics in Patients with Ileal Conduit and Orthotopic Neobladder

Journal of Men s Health ◽

10.15586/jomh.v16i3.246 ◽

2020 ◽

Vol 16 (3) ◽

pp. e38-e46

Author(s):

Seungsoo Lee ◽

Seung Ryong Baek ◽

Won Hoon Song ◽

Tae Nam Kim ◽

Sung-Woo Park ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Radical Cystectomy ◽

Ileal Conduit ◽

Orthotopic Neobladder ◽

Febrile Urinary Tract Infection ◽

Cox Regression Analysis ◽

Significant Difference ◽

Febrile Uti

Background and ObjectiveTo compare the incidence of febrile urinary tract infection (UTI) and bacterial identification between patients with orthotopic neobladder (ONB) and ileal conduit (IC). Materials and MethodsData of 164 patients who underwent radical cystectomy with ONB and IC for bladder cancer between January 2009 and January 2018 at our institution were analyzed. Febrile UTI observed was listed and subsequently compared. Incidence of febrile UTI, clinicopathological characteristics, and microorganisms identified were reported at 3 months interval; and preoperative predictors of febrile UTI were evaluated with Cox regression analysis. Patients were divided into ONB and IC. ResultsThe study cohort included 52 patients with ONB and 112 patients with IC. Febrile UTI was diagnosed in 49 (29.9%) patients. Compared to IC group, ONB group had significantly higher incidence of young age (p=0.00), lower cancer stage (p=0.013), longer hospital stay (p=0.049), longer operation time (p=0.00), and higher incidence of febrile UTI within the first 3 months after surgery (p=0.006). On univariable and multivariable analysis, factors associated with significantly increased febrile UTI risk were diabetes (odds ratio [OR]: 4.52; p=0.002) and ONB diversion (OR: 1.27; p=0.031). Forty-four (89.8%) patients were culture positive. However, significant difference in microorganisms was not detected between patients who under-went ONB or IC diversion. ConclusionDiabetes and ONB diversion were associated with higher risk symptomatic UTI following radical cystectomy.

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Prediction of renal cortical defect and scar using neutrophil-to-lymphocyte ratio in children with febrile urinary tract infection

Nuklearmedizin ◽

10.3413/nukmed-0878-17-01 ◽

2017 ◽

Vol 56 (03) ◽

pp. 109-114 ◽

Cited By ~ 3

Author(s):

Jeong Won Lee ◽

Joon Soo Park ◽

Kyeong Bae Park ◽

Gyeong Hee Yoo ◽

Seung Soo Kim ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Neutrophil To Lymphocyte Ratio ◽

Febrile Urinary Tract Infection ◽

Lymphocyte Ratio ◽

Cortical Defect ◽

Febrile Uti ◽

Dmsa Scan

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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Clinical Characteristics of Febrile Urinary Tract Infection and Application of Thai Guideline Imaging Recommendations Compared between Children Aged 2 Months to 2 Years and Children Aged 2 to 5 Years

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.12.13196 ◽

2021 ◽

Vol 104 (12) ◽

pp. 1977-1983

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Imaging Study ◽

Female Gender ◽

Voiding Cystourethrography ◽

Older Children ◽

Febrile Urinary Tract Infection ◽

Febrile Uti ◽

Imaging Recommendations

Background: In 2014, the Thai Pediatric Nephrology Association (TPNA) launched a guideline for febrile urinary tract infection (UTI) in children aged two months to five years. Renal and bladder ultrasound (RBUS) is recommended for first febrile UTI, and voiding cystourethrography (VCUG) is recommended in patients with at least one of eight proposed risk factors. Objective: To compare characteristics of febrile urinary tract infection (UTI), compliance with the imaging study recommendation regarding to the TPNA guide, and kidney, ureter, and bladder (KUB) abnormality detections between children aged two months to two years and older than two years to five years. Materials and Methods: The present study was a retrospective study, reviewed children aged two months to five years presenting with first or recurrent episode of febrile UTI between 2014 and 2019 at Siriraj Hospital. Clinical parameters during febrile UTI, indications to perform VCUG, and kidney, ureter, and bladder (KUB) abnormality detections were compared between the younger group and the older group. RBUS and VCUG undergone according to the recommendation were accounted for the compliance. Results: The mean age of 259 younger and of 51 older age children was 8.2±5.6 and 40.0±10.9 months, respectively. Female gender (p=0.01), complaint of constipation (p=0.03), abnormal bladder emptying (p<0.01), and renal impairment (p=0.03) were more frequent in the older than the younger. Overall imaging study compliance was 73.9% and the KUB abnormality detection was 16.5%. High-grade vesicoureteral reflux (VUR) was more common than low-grade VUR. The rates of compliance (p=0.45) and KUB abnormality detections (p=0.54) between the younger and older children were not different. Conclusion: Female gender, and bladder and bowel dysfunction were associated to febrile UTI in older children. The TPNA febrile UTI guideline imaging recommendation was shown to be applicable in both younger and older children. Keywords: Clinical characteristics; Febrile urinary tract infection; Thai guideline imaging recommendations; Renal and bladder ultrasound; Voiding cystourethrography

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Use of Intravenous Furosemide to Prevent Febrile UTI Following Flexible Ureterorenoscopic Laser Lithotripsy

Nepal Medical Journal ◽

10.37080/nmj.70 ◽

2019 ◽

Vol 2 (2) ◽

pp. 49-52

Author(s):

Robin Bahadur Basnet ◽

Sanjay Bikram Shrestha ◽

Jitendra Shrestha ◽

Bipin Shrestha

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Statistical Significance ◽

Prophylactic Antibiotic ◽

Renal Stones ◽

Laser Lithotripsy ◽

Febrile Urinary Tract Infection ◽

Holmium Laser Lithotripsy ◽

Febrile Uti

Introduction: Flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm. However, flexible ureterorenoscopic laser lithotripsy is not without complications and urinary tract infection is the most common reported complication. Prophylactic antibiotic use, access sheath, low pressure irrigation are few methods to reduce incidence of urinary tract infection. We have studied whether routine use of intravenous furosemide reduces the incidence of febrile urinary tract infection. Methods: A total of 70 patients were randomized into two groups where one received intravenous furosemide at the beginning of the procedure and another did not. Flexible ureteroscopic holmium laser lithotripsy was done and patients were followed up for development of febrile urinary tract infection within one week of the procedure. Results: 14% of patients who received furosemide and 20% of patients who did not receive developed post- operative febrile urinary tract infection within one week. Two patients in each group had bacteriuria. Conclusions: Although the incidence of febrile UTI is lesser with routine use of intravenous furosemide during flexible ureterorensocopic laser lithotripsy, statistical significance could not be proved.

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Patients with preoperative asymptomatic pyuria are not prone to develop febrile urinary tract infection after ureteroscopic lithotripsy

BMC Urology ◽

10.1186/s12894-021-00919-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kuan-Jung Lin ◽

Eric Y. H. Huang ◽

I-shen Huang ◽

Yu-Hua Fan ◽

Chih-Chieh Lin ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

White Blood Cells ◽

Febrile Urinary Tract Infection ◽

Emergency Visits ◽

Stone Free Rate ◽

Significant Difference ◽

Febrile Uti ◽

Free Rate

Abstract Background This study aimed to evaluate the association of asymptomatic pyuria before ureterorenoscopic lithotripsy (URSL) with postoperative febrile urinary tract infection (UTI). Methods This observational case–control study identified the patients undergoing URSL for ureteral stones between May 2011 and October 2015. The included patients were classified into two groups: the asymptomatic pyuria group (6–50 white blood cells [WBCs]/high-power field [HPF]) and the non-pyuria group (≤ 5 WBCs/HPF). All data were collected by reviewing medical records. Postoperative outcomes were collected in terms of febrile UTI, emergency visits, and stone-free rate. Results A total of 232 patients were included, 101 in the pyuria group, 131 in the non-pyuria group. Two (0.9%) patients developed febrile UTI after URSL and 12 (5.2%) patients visited emergency department for URSL-related symptoms. The overall stone-free rate was 90.9%. There was no significant difference between the pyuria and non-pyuria groups regarding febrile UTI, emergency visits, and stone-free rate. Multivariate analysis revealed that pyuria was neither significantly associated with postoperative febrile UTI (OR = 1.03, 95% CI = 0.06–18.10, P = 0.98), nor with emergency visits (OR = 0.48, 95% CI = 0.13–1.85, P = 0.29). Conclusions Compared to the patients with sterile urine prior to URSL, those with asymptomatic pyuria were not prone to develop febrile UTI after URSL.

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