title: Can absence of pyuria exclude urinary tract infection in febrile infants? About 2011 AAP guidelines on UTI.
abstract: BACKGROUND
  The aim of this study was to describe clinical and laboratory characteristics of urinary tract infection (UTI) without significant pyuria in young children aged 2-24 months.
  
  
  METHODS
  The subjects consisted of infants and young children with febrile UTI treated at Pusan National University Children's Hospital, Korea. Group A included 283 patients with definite UTI who fulfilled the revised American Academy of Pediatrics diagnostic criteria, and group B included 19 patients with presumed UTI who had significant culture of uropathogens without pyuria, bacteriuria or other focus of infection.
  
  
  RESULTS
  Duration of fever before hospital visit in group B was significantly shorter than in group A (17.7 ± 14.0 vs 34.5 ± 30.7 h). Most patients in group B (17/19, 89.5%) came to the hospital within 24 h of onset of fever. Acute scintigraphic lesions were found in 47.8% of patients in group A and 50% in group B. Underlying urological abnormalities such as vesicoureteral reflux and obstructive uropathy were found in 24.5% of patients in group A and in 33.3% of patients in group B (P = 0.74).
  
  
  CONCLUSIONS
  Clinicians cannot exclude UTI on the absence of pyuria in young children aged 2-24 months.
authors.affiliation: Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital.
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Lyu
authors.affiliation: Department of Pediatrics, Pusan National University Hospital, Busan, Korea.
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
authors.forename: Su Eun
authors.initials: SE
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
authors.forename: Su Young
authors.initials: SY
authors.lastname: Kim
mesh_terms: D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D011776:Pyuria / Q000150:complications* / Q000175:diagnosis; D056910:Republic of Korea / Q000453:epidemiology; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000453:epidemiology
keywords: American Academy of Pediatrics guideline; Korea; infant; pyuria; urinary tract infection