A Necessity for Lumbar Puncture and VCUG in Febrile UTI Infants less than 3 Months of Age.
- Author:
Ji Hee KIM
1
;
Jun Ho LEE
Author Information
1. Department of Pediatrics, College of Medicine, Pochon Jungmun University Cha Hospital, Korea. naesusana@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Urinary tract infection;
Bacterial Meningitis;
Voiding cystourethrography
- MeSH:
Humans;
Infant;
Meningitis;
Meningitis, Bacterial;
Prevalence;
Prognosis;
Sepsis;
Spinal Puncture;
Succimer;
Urinary Tract Infections
- From:Journal of the Korean Society of Pediatric Nephrology
2009;13(1):33-39
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Our aim is to reduce the rate of lumbar spinal tapping and voiding cystourethrography (VCUG) in febrile urinary tract infection (UTI) infants less than 3 months of age. METHODS: We reviewed the prevalence of UTI, sepsis, meningitis and UTI with bacterial meningitis in febrile infants less than 3 months of age during the period from Jan. 2001 to Jun. 2008. Renal ultrasonography, Technetium-99m dimercaptosuccinic acid (DMSA) renal scan or VCUG were performed in infants with UTI. Infants with UTI were divided into two groups according to the presence of abnormal findings of ultrasonography and DMSA renal scan : group 1-Infants in whom both ultrasonography and DMSA were normal, group 2-Infants in whom ultrasonography or DMSA were abnormal. Prevalence of VUR was compared between the two groups. We followed up the clinical course of patients who had VUR in group 1. RESULTS: Among 1962 Infants, UTI, sepsis and bacterial meningitis were diagnosed in 620 (31.6%), 63 (3.2%), 8 (0.4%) respectively. Lumbar puncture was performed in 413 (66.6%) infants with UTI and we did not detect a case of bacterial meningitis in association. 348 infants with proven UTI were undergone ultrasonography, DMSA, VCUG. In group 1 with 110 infants (31.6%), the presence of VUR was 4 (3.6%). In group 2 with 238 infants (68.4%), the presence of VUR was 51 (21.4%). Abnormal findings of ultrasonography or DMSA renal scan were closely related with high grade VUR. Most of patients with VUR in group1 had good prognosis. CONCLUSION: Lumbar puncture and VCUG are invasive procedures. Therefore we should decide whether to perform lumbar puncture or VCUG in infants less than 3 months. of age with their first febrile UTI.
