Document Detail


The value of urinalysis in differentiating acute pyelonephritis from lower urinary tract infection in febrile infants.
MedLine Citation:
PMID:  7808845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is an ongoing debate on the best way to screen febrile infants for urinary tract infection. We examined the urinanalysis (UA) findings on admission among infants less than 16 weeks old, with and without acute pyelonephritis (APN), as defined by the dimercaptosuccinic acid (DMSA) renal scan findings, performed during a 57-month period. Forty-nine cases with a positive DMSA scan were compared with 79 negative study cases. A negative UA for leukocytes (< 5 white blood cells/high power field) was found in 4 of 49 (8.1%) cases with APN by DMSA, and in 34 of 79 (43%) cases with a negative DMSA (odds ratio 10.88 (95% confidence interval, 2.31 to 70.3; P < 0.001)). Three of the 4 infants not suspected to have APN by their UA findings would have been admitted for a full sepsis workup based on their clinical presentation and/or their laboratory findings on admission. We conclude that a fresh UA may be a sufficient screening method for the exclusion of APN in infants assessed for fever of no obvious origin.
Authors:
D Landau; M E Turner; J Brennan; M Majd
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  13     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1995-02-02     Completed Date:  1995-02-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  777-81     Citation Subset:  IM    
Affiliation:
Department of Nephrology, George Washington School of Medicine, Washington, DC.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Bacterial Infections / complications,  diagnosis*
Diagnosis, Differential
Female
Fever of Unknown Origin / etiology*
Humans
Infant
Infant, Newborn
Leukocyte Count
Male
Pyelonephritis / complications,  diagnosis*,  microbiology,  radionuclide imaging
Retrospective Studies
Succimer
Urinalysis*
Urinary Tract Infections / complications,  diagnosis*,  microbiology,  radionuclide imaging
Chemical
Reg. No./Substance:
304-55-2/Succimer

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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