A Single Center Study of the Necessity for Routine Lumbar Puncture in Young Infants with Urinary Tract Infection.
10.14776/piv.2017.24.1.54
- Author:
Chang Ho LEE
1
;
Kye Hyang LEE
Author Information
1. Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, the Republic of Korea. rosalia@cu.ac.kr
- Publication Type:Original Article
- Keywords:
Infant;
Urinary tract infections;
Spinal puncture
- MeSH:
Academic Medical Centers;
Bacterial Infections;
Body Temperature;
Cerebrospinal Fluid;
Consensus;
Daegu;
Enterovirus;
Humans;
Infant*;
Length of Stay;
Leukocyte Count;
Leukocytosis;
Medical Records;
Meningitis;
Meningitis, Bacterial;
Meningitis, Viral;
Polymerase Chain Reaction;
Prevalence;
Retrospective Studies;
Sepsis;
Spinal Puncture*;
Urinalysis;
Urinary Tract Infections*;
Urinary Tract*
- From:Pediatric Infection & Vaccine
2017;24(1):54-59
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Urinary tract infection (UTI) is the most common serious bacterial infection in infants younger than 3 months of age. Lumbar puncture is routinely performed to evaluate febrile young infants for sepsis. However, there is no clear consensus on the use of routine lumbar puncture to diagnose concomitant meningitis in infants with UTI. We evaluated the prevalence of coexisting bacterial meningitis and sterile cerebrospinal fluid (CSF) pleocytosis in young infants with UTI. METHODS: We retrospectively reviewed the medical records of 85 infants with UTI, aged from 29 to 99 days, who were admitted to Daegu Catholic University Medical Center from January 2013 to May 2016. We included 80 patients who had undergone lumbar puncture. Demographic features, clinical features, and laboratory findings were analyzed. Patients were divided into two groups based on the presence of sterile CSF pleocytosis and we compared these groups and assessed the differences between them. RESULTS: Of the 80 UTI patients enrolled, 34 (43%) had sterile CSF pleocytosis. None had bacterial meningitis, and CSF polymerase chain reaction for enterovirus was positive in two patients without CSF pleocytosis. There were no significant differences between the two groups with regards to age, body temperature, peripheral white blood cell count, urinalysis, and duration of hospital stay. CONCLUSIONS: Though sterile CSF pleocytosis is common in young UTI patients, coexisting bacterial or viral meningitis is very rare. Indications for lumbar puncture in these patients depend on clinical condition.
