Screening of young children between 2-24 months of Age with a first febrile UTI for VUR with imaging modalities

Abstract

Background: Urinary tract infection (UTI) is one of the most common serious bacterial illnesses affecting children. The presence of moderate to severe vesicouretheral reflux (VUR), particularly if bilateral, is an important risk factor for pyelonephritis and renal scarring. Imaging studies, including renal ultrasonography (USG), technetium-99m– labelled dimercaptosuccinic acid (DMSA) scanning, and voiding cystourethrography (VCUG), are part of standard care after diagnosis of a first UTI in young children. This study was done to determine the sensitivity, specificity and predictive values of renal USG and DMSA scan findings for VUR. Methods: All children between 2-24 months of age presenting with first febrile UTI were prospectively studied. All infants were hospitalized and investigated using renal USG, DMSA scan, and VCUG after diagnosis. The association among findings of USG, DMSA scan, and VCUG were evaluated. Results: A total of 48 children were included in the study and screened, out of which there were abnormal results in 22 (45.8%) USG and 29(60.4%) DMSA scan. All grade VUR (I-V) was present in 8(16.7%) patients and high grade VUR (III-V) was present in 7(14.6%) patients. The sensitivities for detecting VUR of renal USG alone (75%) or DMSA scan alone (87.5%) were not as good as that of the “OR rule” strategy, which had 100% sensitivity and 100% negative predictive value. Conclusions: Renal USG and DMSA scanning both should be routinely performed in young children with a first febrile UTI. VCUG is only indicated when abnormalities are apparent on either USG scanning or DMSA scanning or both.

Authors and Affiliations

Alkarani T Patil, Sanjeeva G N, Yogesh R, Sowmya K, Ramesh L

Keywords

Related Articles

Ultrasound guided reduction of intussusception by use of saline enema in children-our experience in 58 cases in eastern India

Background: Our aim of study is to evaluate the reduction of ileo-colic intussusception by ultrasound guided saline enema in children. Methods: This is a retrospective study of 58 cases of pediatric ileo-colic intussusce...

Factors affecting the outcome in multiple gestations

Introduction: Twin births are the commonest form of multiple births. Twins have attracted considerable attention and excited curiosity from early times as a biological variety in the study of the human species. Twin preg...

Prevalence of microcytic hypocromic anemia in children with LRTI in the age group of 3 months to 5year: Is iron deficiency anemia a risk factor for LRTI?

Introduction: Lower respiratory tract infection (LRTI) include all infections of the lungs and the large airways below the larynx and includes croup syndromes, bronchitis, bronchiolitis and pneumonia. Anemia is a major p...

Intra-operative squash cytodiagnosis of pleomorphic xanthoastrocytoma : A diagnostic challenge

Pleomorphic xanthoastrocytoma (PXA) is WHO grade II tumor representing less than 1% of all astrocytic tumors. It displays cellular atypia and pleomorphism to such an extent that it can be misdiagnosed as a high grade gli...

Aches and Pain in a child- An unusual cause

Precursor B-cell lymphoblastic lymphoma presenting with severe pain and extensive skeletal lesions as an initial presentation is very rare. We report a nine year old boy who presented with lower backache and difficulty i...

Download PDF file
  • EP ID EP324417
  • DOI 10.17511/ijpr.2015.4.011
  • Views 145
  • Downloads 0

How To Cite

Alkarani T Patil, Sanjeeva G N, Yogesh R, Sowmya K, Ramesh L (2015). Screening of young children between 2-24 months of Age with a first febrile UTI for VUR with imaging modalities. Pediatric Review: International Journal of Pediatric Research, 2(4), 88-94. https://europub.co.uk./articles/-A-324417