Screening of young children between 2-24 months of Age with a first febrile UTI for VUR with imaging modalities
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2015, Vol 2, Issue 4
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
- EP ID EP324417
- DOI 10.17511/ijpr.2015.4.011
- Views 137
- Downloads 0
Knowledge of febrile convulsion among mothers attending the paediatric clinic of university of Uyo teaching hospital, Nigeria
Background: Febrile convulsion is a common emergency encountered in Paediatric practice. Inadequate knowledge could result in parental anxiety, apprehension and improper home management. Aim: To determine the knowledge,...
Prospective study for newborn hearing screening-A experience from tertiary care centre in central India
Background: It is crucial to timely diagnose hearing impairments in infants as early intervention can lead to decrease in morbidity and better prognosis. This study was conducted as an attempt to find the incidence of he...
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...
Neonatal behavioral assessment among survivors of birth asphyxia using T.Berry Brazelton's NBAS
Introduction: This study aims at providing baby-specific prognosisfor the survivors of birth asphyxia,regarding their neurological impairment, based on their behaviour assessment using T. Berry Brazelton′s NBAS. Methods:...
Study of C-reactive protein in healthy neonates
Introduction:C-reactive protein is widely used marker for early detection of neonatal sepsis. There is reported wide variation in normal CRP level of new born as well as its sensitivity and specificity regarding its use...