Primary urinary tract infection in infants: prophylaxis for uncomplicated pyelonephritis.
BACKGROUND
Urinary tract infection (UTI) is one of the most common causes of unexplained fever in infants with a reported prevalence range of 5-11%. The clinical and laboratory findings were reviewed, and diagnosis and treatment for 95 infants with primary UTI were evaluated in this study.


METHODS
All patients underwent renal ultrasonography, voiding cystourethrogram and 99mTc dimercaptosuccinic acid (DMSA) scan during hospitalization before treatment, with treatment consisting of 2- or 4-week appropriated antibiotic therapy for the patients associated upper UTI, followed by a second DMSA scan 6 months after therapy.


RESULTS
In the present study the main symptom of UTI in infants was fever. High white blood cell count was not necessarily present, and urinalysis was also an imperfect diagnostic tool for discriminating UTI. In addition, colony count from urine culture and kidney ultrasonography was not efficacious in terms of predicting the occurrence of pyelonephritis. Intravenous antibiotic for 1 week followed by 3 weeks of the same oral antibiotic provided good prophylaxis for uncomplicated pyelonephritis.


CONCLUSIONS
Four weeks of antibiotic treatment resulted in good recovery from pyelonephritis in the present sample of infant primary UTI cases. voiding cystourethrogram, DMSA and ultrasonography scanning should be performed in primary infant UTI.
Wan
Kong-Sang
KS
Department of Pediatrics, Taipei City Hospital, Yangming Branch and School of Medicine, National Yang-Ming University, Tapei, Taiwan. gwan1998@gmail.com
Liu
Chih-Kuang
CK
Chen
Li-Hui
LH
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D007958:Leukocyte Count; D008297:Male; D020613:Morganella morganii / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D011704:Pyelonephritis / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control*; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods; D014552:Urinary Tract Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D014556:Urine / Q000382:microbiology; D014567:Urography / Q000379:methods
D000900:Anti-Bacterial Agents; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid