Role of imaging in children with urinary tract infections

Abstract

Background: As per recommendation from the American Academy of pediatrics a child with first episode of urinary tract infection should be evaluated for underlying urinary tract abnormalities by undergoing voiding cystourethrogram, ultrasonogram of urinary tract and radionuclide imaging of kidney. We studied role of these imaging studies in picking up renal abnormalities.Methods: We conducted a descriptive study in which 100 children aged 1mth-12 years with documented urinary tract infection (UTI) were included. Ultrasonogram (USG) and radionuclide renal scan were obtained at the time of admission. Voiding cystourethrography (VCUG) was performed after 6weeks to look for vesicoureteric reflux.Results: Forty three children underwent both DMSA and follow up VCUG. Ultrasonogram picked up acute pyelonephritis (APN) in 7.1% of children with UTI while 31.1% had pyelonephritis on DMSA. Overall incidence of VUR was 16.3%. The sensitivity of USG for VUR detection was only 14.2%. The sensitivity of USG as a screening test for APN is 7%.Conclusions: All children less than five years with UTI must undergo DMSA and VCUG. Ultrasonography is less sensitive in detecting VUR and acute pyelonephritis.

Assessment of the Incidence and Associated Risk Factors of Urinary Tract Infection among children- A Retrospective studyAssessment of the Incidence and Associated Risk Factors of Urinary Tract Infection among children- A Retrospective study

“…2 The Possibility of Urinary Tract Infection must to be considered in all febrile children and urine culture specimen must be collected as a part of diagnostic evaluation. 1 One studies shows that the management of children with urinary tract infection doesn't stop with treating that episode with antibiotics,whereas is has higher chance of associated urinary tract abnormalities like vesicoureteric reflux, pelviuureteric junction obstruction, ureteroceles that may result in recurrent infections and permanent damage to kidneys in the form of renal scarring. UTI at this critical and vulnerable age group is associated with considerable morbidity because it can lead to serious complications such as hypertension, renal scarring and end-stage renal failure.…”