title: Early treatment of urinary infection prevents renal damage on cortical scintigraphy.
abstract: Diagnosis of urinary infection in young children is often delayed, which may result in renal damage. However, it remains to be clarified how soon the treatment should be started to prevent renal changes. The present study prospectively enrolled young children with diagnosis of their first febrile urinary infection who underwent technetium-99m dimercaptosuccinate renal cortical scintigraphy within 120 h of initiation of treatment. Patients with abnormal renoscintigraphy received antibiotics for 2 weeks and scintigraphy was repeated 1 year later. Twenty-two children were enrolled from July 1995 through March 2000. Acute-phase renoscintigraphy identified focal defects in 0 of the 14 children who were treated within 24 h of the disease, 1 of the 3 treated in 24-48 h, and 2 of the 5 treated in 48-72 h. Repeat renoscintigraphy showed disappearance of the focal defects in all 3 children. The present study has shown that early treatment within 24 h of onset of the fever due to urinary infection should deter renal changes. Fever for more than 24 h prior to diagnosis indicates a high risk for renal changes and needs an immediate effective treatment to avoid renal damage.
authors.affiliation: Department of Pediatrics, Fukui Medical University School of Medicine, Matsuoka, Fukui 910-1193 Japan. hiraoka@fmsrsa.fukui-med.ac.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hiraoka
authors.forename: Gotaro
authors.initials: G
authors.lastname: Hashimoto
authors.forename: Shinya
authors.initials: S
authors.lastname: Tsuchida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tsukahara
authors.forename: Yusei
authors.initials: Y
authors.lastname: Ohshima
authors.forename: Mitsufumi
authors.initials: M
authors.lastname: Mayumi
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007672:Kidney Cortex / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D011866:Radioisotope Renography; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013997:Time Factors; D014552:Urinary Tract Infections / Q000188:drug therapy*
chemical_list: D019783:Technetium Tc 99m Dimercaptosuccinic Acid