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Archivos de Pediatría del Uruguay

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Abstract

CAGGIANI, MARINA; BARREIRO, ANA  and  SCHOL, PALOMA. Infección urinaria en niños internados: características clínicas, bacteriológicas e imagenológicas. Arch. Pediatr. Urug. [online]. 2002, vol.73, n.4, pp. 203-211. ISSN 0004-0584.

Urinary tract infection (UTI) is the nephrologic disease that most commonly determines hospital admission in children. The purpose of this prospective study is to analize the clinical, bacteriologic and imagenologic caratheristics of children with this disease in a Pediatric hospital setting. Sixty children were admitted with the diagnosis of UTI in the period 9/2001- 5/2002. 85% were less than 2 years old; 65% were females. Fever was the most frecuent symptom, gastrointestinal manifestations were second in importance, cystitis syndrome was observed in 10% of the patients. Escherichia coli was the predominant etiologic agent: 81,7%, Klebsiella in 10%, Proteus 3,3%, Enterobacter 1,7%. It was observed low sensitivity of these bacterias to ampicillin and cefalotine, intermediate to trimetroprim-sulfametoxasol and high sensitivity to cefuroxime. The renal ecography was abnormal in 19,3% with a low sensitivity to detect parenchymal anomalies observed in DMSA scintigraphy: 12,5% as well as vesicoureteral reflux(VUR):  36%. DMSA renal scans demonstrated pathological results in 65% of the patients. The association of fever, leukocytosis >15.000/mm3 and positive C reactive protein was more frecuent with positive DMSA scans (44%) than in cases of negative DMSA (12%). In two patients with equivocal urine cultures DMSA scan allowed the diagnosis of acute pyelonephritis. The voiding cystourethrography showed VUR in 40,7% of the patients. This study couldn’t be performed in a high number of children (55%) because of lack of compliance. In consequence, this important pathology must be underdiagnosed and obliges to plan different strategies to detect it.

Keywords : URINARY TRACT INFECTIONS [etiology]; DIAGNOSTIC IMAGING.

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