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KMID : 1218220090010020094
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Korean Journal of Pediatric Urology
2009 Volume.1 No. 2 p.94 ~ p.99
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The Vesicoureteral Reflux in Children Suspected of Febrile Urinary Tract Infections
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Baek Min-ki
Kang Myung-Beom
Lee Byung-Ki
Jun Kyung-Kyu
Paick Sung-Hyun
Kim Hyeong-Gon
Kim Kyo-Sun
Lho Yong-Soo
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Abstract
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Purpose: To evaluate the possibility of vesicoureteral reflux (VUR) according to various clinical situations in the children suspected of febrile urinary tract infections (UTIs).
Patients and Methods: Two hundred thirty three children who were suspected of febrile UTIs and underwent voiding cystourethrographies were reviewed retrospectively. All patients had high fever with more than 3 grade of pyuria. The patients were classified according to age, sex, severity of pyuria, presence of bacteria on urine culture, and renal ultrasonography (US) findings. The possibility of VUR was analysed according to the various clinical situations.
Results: The median age of the patients at the evaluation was 5.9 months, ranging from 1-126 months. Boys are more likely to have febrile UTIs than girls under 6 months age, but the proportion of boys in febrile UTI children was decreased over 6 months age. Of the 233 children, 33 (14.2%) were found to have VURs. The possibility of VUR was increased with the severity of pyuria, presence of bacteria on urine culture, and the abnormalities on renal US. Of the 8 children who had abnormalities on US, 5 (63.0%) had high grade VUR.
Conclusions: Pediatric populations need special considerations because children have difficulty to express their urinary symptoms and collect appropriate urine specimens. Suspicion for other febrile focus with clinical symptoms and sign including severity of pyuria, urine cultural result, and the US findings should be considered for the evaluation of VUR in the children suspected of febrile UTIs.
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KEYWORD
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Urinary tract infection, Pediatrics, Vesicoureteral reflux
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