Renal ultrasonography with the first UTI

Abstract

Increasingly, the long-term benefits of identifying children with low-grade vesicoureteral reflux, as well as the use of prophylactic antibiotics in attempt to prevent recurrent urinary tract infection (UTI) and eventual renal morbidity, are being questioned. The report by Ismaili et al from Belgium contributes to the conversation. Investigators performed a prospective 2-year cohort study of 43 infants from the time of first febrile UTI at the age of less than 3 months. Ultrasonography (US) and voiding cystourethrography were performed on all infants, and 91% were followed for a mean of 20 ± 9 months. In 67% of infants, US was normal. No infant with normal US had a congenital anomaly of the kidney or urinary tract or high-grade reflux by voiding cystourethrography. In 21% of the study population, vesicoureteral reflux was identified. In the 67% of infants with low grade reflux, all cases were resolved during follow up. UTI recurred in only 14% of the study group (first episode at a mean follow-up time of 8.3 ± 7 months); one-half of recurrences were in infants with congenital anomalies of the kidney or urinary tract, although such children made up only about 20% of the cohort. Article page 69 ▸ Febrile Urinary Tract Infections in 0- to 3-Month-Old Infants: A Prospective Follow-Up StudyThe Journal of PediatricsVol. 158Issue 1PreviewTo track the clinical evolution of febrile urinary tract infection (UTI) diagnosed in 0- to 3-month-old infants and characterize uropathogen frequencies, antimicrobial resistance rates, renal abnormalities, and differences in the sexes in this age group. Full-Text PDF