A Comparison of Clinical Findings According to the Duration of Pyuria in Infants with Urinary Tract Infections.
- Author:
Jeong Eun LEE
;
Seung Woo LEE
;
So Hyun PARK
;
Jong Hyun KIM
;
Dae Kyun KOH
- Publication Type:Original Article
- Keywords:
Pyuria;
Urinary tract infection;
Vesicoureteral reflux
- MeSH:
Blood Sedimentation;
C-Reactive Protein;
Child;
Early Diagnosis;
Fever;
Humans;
Hydronephrosis;
Incidence;
Infant;
Leukocyte Count;
Pyuria;
Retrospective Studies;
Urinary Tract;
Urinary Tract Infections;
Vesico-Ureteral Reflux
- From:Korean Journal of Pediatric Infectious Diseases
2010;17(1):23-29
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs. METHODS: Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment. RESULTS: There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count (14,360.86+/-5,526.16 cells/mm3 vs. 11,822.55+/-5,687.26 cells/mm3, P<0.001), erythrocyte sedimentation rate (32.81+/-19.34 mm/hr vs. 23.74+/-20.43 mm/hr, P<0.001), and C-reactive protein (6.84+/-5.68 mg/dL vs. 3.78+/-3.99 mg/dL, P<0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1. CONCLUSION: In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.
