INCIDENCE OF URINARY TRACT INFECTION AMONG FEBRILE CHILDREN

Abstract

Urinary tract infection (UTI) is the most common serious bacterial infection in young febrile children. The diagnosis and management of UTI in young children are clinically challenging. The aim of this study is to determine the incidence of UTI among febrile children of different ages presented with specific or non-specific symptoms suggestive of UTI. This cross sectional study was carried out on febrile children attending the outpatient clinic at Al-Hussein University Hospital from January to July 2014. A total of 200 febrile patients selected randomly aged 1-12 years were included in the study .They were 51 males and 149 females. Inclusion criteria were children from 1-12 years with explained or unexplained fever of 38oc or higher, children with nonspecific symptoms of UTI such as lethargy, irritability, malaise, failure to thrive, vomiting, poor feeding and children with specific symptoms of UTI, such as increased frequency, dysuria, suprapubic pain, loin pain and tenderness. Exclusion criteria were patients on antibiotic treatment, patients with known history of recurrent UTI and patients with well-known urinary tract anomalies before or during the study.All patients enrolled in this study were subjected to Full history taking, clinical examination, complete urine analysis, culture and sensitivity, routine investigations as CBC, ESR, CRP and renal ultrasonography. The results clarified that dysuria was the predominant among urinary tract symptoms (6.5%) while sore throat was the predominant among symptoms other than UTI (60%). There was a statistically significant difference between febrile children and the level of Pyuria where febrile children having pus cells more than 10 / HPF considered significant for the infection, p-value is < 0.001. All patients with pyuria ( 16 patients) were positive for nitrite test and urine culture. From this study, we can conclude that; unexplained fever is one of the common presenting symptoms of UTI and screening for UTI by strip nitrite test (simple, easy with immediate result) among febrile infants and children is an important mean for early detection of infection. We also recommend considering UTI in febrile patients with nonspecific symptoms or minimal symptoms of different systems.