Abstract
Introduction: Fever is the most common reason for children 1-5 years of age to visit Emergency / out patient departments. Little attention has been focused on the identification of urinary tract infections in febrile children, despite recent information that suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients. This study is undertaken to determine the prevalence of urinary tract infection in febrile children one year to five years of age and to evaluate various diagnostic methods for a case of Urinary tract infection. Method: Febrile children (rectal ≥38.3˚C or auxiliary temperature ≥37.8˚C) of 1 to 5 years of age were studied over a period of 12 months February 2015 to January 2016 at our tertiary care centre. History and relevant investigations were done. Result: The study included 200 children. The overall prevalence rate of urinary tract infection in the present study was 5.5% with prevalence in children 1-2 years of age 2%. 13.5% of cases showed significant pyuria. Among pyuric patients 40.74% were culture positive with a M:F of 1.2:6. USG done in significant pyuric cases revealed renal involvement /anomaly in 6 cases. Conclusion: Clinicians should consider obtaining a urine specimen as part of their diagnostic evaluation as urinary tract infection is a possibility in febrile children. Pyuria of ≥ 5 pus cells /HPF in centrifuged sample should be considered as significant pyuria and further evaluation should be done promptly to initiate treatment and to prevent morbidity and long term sequalae.
Highlights
Fever is the most common reason for children 1-5 years of age to visit Emergency / out patient departments
Unlike occult bacteremia or severe bacterial illness, little attention has been focused on the identification of urinary tract infections in febrile children in the emergency department, despite recent information suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients
Clinicians should be aware of the possibility that febrile children may have urinary tract infection and should consider obtaining a urine culture specimen as part of their diagnostic evaluation
Summary
Fever is the most common reason for children 1-5 years of age to visit Emergency / out patient departments. Little attention has been focused on the identification of urinary tract infections in febrile children, despite recent information that suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients. This study is undertaken to determine the prevalence of urinary tract infection in febrile children one year to five years of age and to evaluate various diagnostic methods for a case of Urinary tract infection. Unlike occult bacteremia or severe bacterial illness, little attention has been focused on the identification of urinary tract infections in febrile children in the emergency department, despite recent information suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients. The risk of APN increases when bladder infection occurs in patients Vesicoureteral reflux (VUR), because colonized lower tract urine has direct retrograde access to the upper tract [5]
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