Korean J Pediatr Infect Dis.  2010 Jun;17(1):23-29.

A Comparison of Clinical Findings According to the Duration of Pyuria in Infants with Urinary Tract Infections

Affiliations
  • 1Department of Pediatrics, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Korea. nicedoc@catholic.ac.kr

Abstract

PURPOSE
Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs.
METHODS
Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment.
RESULTS
There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count (14,360.86+/-5,526.16 cells/mm3 vs. 11,822.55+/-5,687.26 cells/mm3, P<0.001), erythrocyte sedimentation rate (32.81+/-19.34 mm/hr vs. 23.74+/-20.43 mm/hr, P<0.001), and C-reactive protein (6.84+/-5.68 mg/dL vs. 3.78+/-3.99 mg/dL, P<0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1.
CONCLUSION
In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.

Keyword

Pyuria; Urinary tract infection; Vesicoureteral reflux

MeSH Terms

Blood Sedimentation
C-Reactive Protein
Child
Early Diagnosis
Fever
Humans
Hydronephrosis
Incidence
Infant
Leukocyte Count
Pyuria
Retrospective Studies
Urinary Tract
Urinary Tract Infections
Vesico-Ureteral Reflux
C-Reactive Protein
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