Management of paediatric recurrent urinary tract infections and challenges in special patient populations

Petcu, Clara T; Stehr, Emma; Isaac, James P; Desai, Devang

doi:10.31128/ajgp-03-21-5922

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…In children, in the case of rUTI, an underlying disorder should be meticulously researched because the lack of diagnosis of the predisposing factor for rUTI may expose the patient to chronic infections, antibiotic therapy failure, and eventually lead to kidney damage ( 3 ). It is estimated that approximately 8.4% of girls and 1.7% of boys under the age of six suffer from UTI within the first 6 years of life ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Hydrometrocolpos conditioning recurrent urinary tract infections

et al. 2022

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We present a case of a 12.5-year-old girl who has suffered from recurrent urinary tract infections for many years but has never undergone a detailed diagnostic process. Only as a teenager did she complain of acute pain in her lower abdomen and it turned out that her genital organs had not properly developed. She had an obstructive defect in the reproductive tract. When there was a significant amount of discharge collected in the lumen of the genital tract and the organs had distended, acute pain appeared, which allowed us to make the diagnosis. In the diagnostic process, transperineal ultrasonography turned out to be extremely helpful, allowing us to establish the type and thickness of the obstruction. The patient underwent excision of transverse vaginal septum, and postoperative silicon dilators were used to prevent the recurrence of the obstruction. There was no recurrence of urinary infection or complications during the 11 months of follow-up.

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Section: Discussionmentioning

confidence: 99%

Case report: Hydrometrocolpos conditioning recurrent urinary tract infections

et al. 2022

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“…Diferentemente dos adultos, as ITUs em crianças frequentemente apresentam manifestações sutis e inespecíficas, exigindo uma abordagem clínica criteriosa para o diagnóstico precoce (Petcu et al, 2021).…”

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Infecção Do Trato Urinário Em Pediatria: Abordagens Diagnósticas E Terapêuticas - Uma Revisão Bibliográfica De Literatura

Mainardo Rodrigues Bezerra,

Araújo Nogueira,

Peres Costa

et al. 2024

RECIMA21

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As infecções do trato urinário (ITU) quando não devidamente diagnosticadas e tratadas, podem acarretar complicações a curto e longo prazo, impactando não apenas a saúde atual, mas também o desenvolvimento renal futuro. Objetivo: Analisar as abordagens diagnósticas e terapêuticas da ITU na faixa etária pediátrica. Metodologia: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e SciELO Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2014 e 2024, que abordassem sobre as abordagens diagnósticas e terapêuticas da ITU na faixa etária pediátrica. Após a análise, foram selecionados 16 artigos para a confecção dessa revisão bibliográfica. Resultados e Discussão: A incorporação de exames complementares desempenha um papel crucial na abordagem diagnóstica da ITU em pacientes pediátricos, particularmente diante da apresentação atípica dos sintomas. A abordagem terapêutica geralmente inclui a administração de antibióticos, cuidados de suporte e, quando necessário, investigação adicional para identificar possíveis anomalias do trato urinário. Conclusão: As ITUs pediátricas, embora comuns, apresentam desafios diagnósticos devido à sintomatologia muitas vezes atípica e à dificuldade de comunicação em pacientes mais jovens. Dessa forma, é evidente que o diagnóstico e tratamento precoces são fundamentais para assegurar a saúde e bem-estar das crianças afetadas.

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Conflicting views of physicians and surgeons concerning pediatric urinary tract infection: a comparative review

Hewitt,

Roebuck,

Montini

2023

Pediatr Radiol

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Background A first febrile urinary tract infection (UTI) is a common condition in children, and pathways of management have evolved over time. Objective To determine the extent to which pediatricians and surgeons differ in their investigation and management of a first febrile UTI, and to evaluate the justifications for any divergence of approach. Materials and methods A literature search was conducted for papers addressing investigation and/or management following a first febrile UTI in children published between 2011 and 2021. Searches were conducted on Medline, Embase, and the Cochrane Controlled Trials Register. To be eligible for inclusion, a paper was required to provide recommendations on one or more of the following: ultrasound (US) and voiding cystourethrogram (VCUG), the need for continuous antibiotic prophylaxis and surgery when vesicoureteral reflux (VUR) was detected. The authorship required at least one pediatrician or surgeon. Authorship was categorized as medical, surgical, or combined. Results Pediatricians advocated less imaging and intervention and were more inclined to adopt a “watchful-waiting” approach, confident that any significant abnormality, grades IV–V VUR in particular, should be detected following a second febrile UTI. In contrast, surgeons were more likely to recommend imaging to detect VUR (p<0.00001), and antibiotic prophylaxis (p<0.001) and/or surgical correction (p=0.004) if it was detected, concerned that any delay in diagnosis and treatment could place the child at risk of kidney damage. Papers with combined authorship displayed intermediate results. Conclusion There are two distinct directions in the literature regarding the investigation of an uncomplicated first febrile UTI in a child. In general, when presented with a first febrile UTI in a child, physicians recommend fewer investigations and less treatment, in contrast to surgeons who advocate extensive investigation and aggressive intervention in the event that imaging detects an abnormality. This has the potential to confuse the carers of affected children.

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Management of paediatric recurrent urinary tract infections and challenges in special patient populations

Abstract: Management of paediatric recurrent urinary tract infections and challenges in special patient populations

Cited by 3 publications

References 32 publications

Case report: Hydrometrocolpos conditioning recurrent urinary tract infections

Case report: Hydrometrocolpos conditioning recurrent urinary tract infections

Infecção Do Trato Urinário Em Pediatria: Abordagens Diagnósticas E Terapêuticas - Uma Revisão Bibliográfica De Literatura

Conflicting views of physicians and surgeons concerning pediatric urinary tract infection: a comparative review

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