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Can absence of pyuria exclude urinary tract infection in febrile infants? About 2011 AAP guidelines on UTI
Author(s) -
Kim Seong Heon,
Lyu Soo Young,
Kim Hye Young,
Park Su Eun,
Kim Su Young
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12853
Subject(s) - medicine , pyuria , urinary system , pediatrics , intensive care medicine
Abstract Background The aim of this study was to describe clinical and laboratory characteristics of urinary tract infection (UTI) without significant pyuria in young children aged 2–24 months. Methods The subjects consisted of infants and young children with febrile UTI treated at Pusan National University Children's Hospital, Korea. Group A included 283 patients with definite UTI who fulfilled the revised American Academy of Pediatrics diagnostic criteria, and group B included 19 patients with presumed UTI who had significant culture of uropathogens without pyuria, bacteriuria or other focus of infection. Results Duration of fever before hospital visit in group B was significantly shorter than in group A (17.7 ± 14.0 vs 34.5 ± 30.7 h). Most patients in group B (17/19, 89.5%) came to the hospital within 24 h of onset of fever. Acute scintigraphic lesions were found in 47.8% of patients in group A and 50% in group B. Underlying urological abnormalities such as vesicoureteral reflux and obstructive uropathy were found in 24.5% of patients in group A and in 33.3% of patients in group B ( P = 0.74). Conclusions Clinicians cannot exclude UTI on the absence of pyuria in young children aged 2–24 months.