title: Hepatic and pulmonary nodular lesions in pediatric urinary tract infections.
abstract: One of the major goals in investigating children with urinary tract infection (UTI) is to recognize patients at risk of further UTI-related problems. This study reports the clinical features of 19 pediatric patients with UTIs in whom associated hepatic and/or pulmonary nodules were incidentally diagnosed by the imaging tests performed for the UTI. Hepatic nodules in five patients were detected on ultrasound scans, and pulmonary nodules and both hepatic and pulmonary nodules were detected in 12 and two children by dimercaptosuccinic acid scintigraphy. The mean age of the patients was 24.5 months. Vesicoureteral reflux (VUR) was detected in nine of 17 patients (52.9%), acute pyelonephritis was identified in nine of 18 patients, and renal scarring was found in 57.1% patients with pyelonephritis. On follow-up, the hepatic and/or pulmonary nodules regressed in all patients. About 85.7% of patients experienced a recurrence of UTI within 1 year. In comparison with age- and sex-matched controls with UTIs without pulmonary or hepatic nodules, the presence of VUR and the recurrence of UTI within 1 year were higher in patients with UTIs and nodules (P<0.05). The hepatic and/or pulmonary nodules identified on the ultrasound scan and by dimercaptosuccinic acid scintigraphy may provide a valuable diagnostic marker for the proper management of patients with an UTI.
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, 152-703, Korea.
authors.forename: Hyung Eun
authors.initials: HE
authors.lastname: Yim
authors.forename: Byung Min
authors.initials: BM
authors.lastname: Choi
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Rhie
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Yoo
authors.forename: Young Sook
authors.initials: YS
authors.lastname: Hong
authors.forename: Joo Won
authors.initials: JW
authors.lastname: Lee
mesh_terms: D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D055613:Multiple Pulmonary Nodules / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014552:Urinary Tract Infections / Q000150:complications* / Q000175:diagnosis; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology*