Imaging Strategy for Infants With Urinary Tract Infection: A New Algorithm

Abstract

C-reactive protein can be used as a predictor of permanent renal damage in infants with urinary tract infection and together with anteroposterior diameter serves as a basis for an imaging algorithm.

Renal swelling indicates renal damage in infants with their first urinary tract infection

“…The patients were consecutively included at our hospital, which is the primary centre for infants with UTIs in the uptake area, and constitute a representative group of infants in the studied population. We found that maximum temperature, CRP and dilated VUR were associated with both acute and one‐year DMSA scan findings, which was in accordance with previous studies . Permanent damage was more likely to occur in children who were female and had a high temperature, high CRP and dilated VUR.…”

Screening high-grade vesicoureteral reflux in young infants with a febrile urinary tract infection

“…Moreover, VCUG is an invasive procedure with radiation burden, discomfort due to the need for catheterization, and a risk of iatrogenic infection. There is a trend toward using less invasive methods to evaluate children with UTI first and to perform VCUG more selectively [2][3][4]. Recent metaanalyses of published data shows that low-grade VUR is of low clinical significance and does not need to be diagnosed and treated [5].…”

Pitfalls and Limitations of Radionuclide Renal Imaging in Pediatrics

“…If the DMSA is normal, then there is no risk of renal scarring following the UTI. 2 The worst possible time of doing a DMSA after a UTI is probably at 6-8 weeks, because it is too early to be able to tell that there are renal scars and it may be too late to detect renal parenchymal acute inflammatory involvement. .…”