title: Kidney imaging in management of delayed febrile urinary tract infection.
abstract: We report a cross-sectional study performed to evaluate the imaging findings of 40 children, aged one month to five years (16.65 ± 14.97 months), who presented with protracted fever of more than 48 hours due to urinary tract infection (UTI). About 85% of the patients had positive Tc99-Dimercaptosuccinic acid (DMSA) scan and 58% had vesicoureteral reflux (VUR). Kidney sonography aided in the diagnosis and treatment in 10% of the patients. Age, sex, presence or laterality of VUR did not contribute to defective DMSA scan (pyelonephritis) (P > 0.05). Delayed diagnosis and treatment of febrile UTI is associated with a high incidence of positive findings of DMSA scan irrespective of age, sex or presence/absence of VUR. In mild VUR, the DMSA scan may be normal while in patients with moderate and severe VUR the DMSA scan is almost always abnormal. Thus, our study shows that a normal DMSA scan can help in ruling out moderate to severe forms of VUR and that cystography remains an excellent and standard tool for the diagnosis of VUR.
authors.affiliation: Department of Pediatric Nephrology, Tabriz Medical University, Tabriz, Iran.
authors.forename: Sayed Abolhassan
authors.initials: SA
authors.lastname: Sayedzadeh
authors.forename: Majid
authors.initials: M
authors.lastname: Malaki
authors.forename: Maryam
authors.initials: M
authors.lastname: Shoaran
authors.forename: Massood
authors.initials: M
authors.lastname: Nemati
mesh_terms: D002614:Chelating Agents; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D011379:Prognosis; D011877:Radionuclide Imaging; D004113:Succimer; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging
chemical_list: D002614:Chelating Agents; D004113:Succimer