title: Paediatric Urinary Tract Infection: A Hospital Based Experience.
abstract: BACKGROUND
  Paediatric Urinary Tract Infection (UTI) is one of the commonly encountered entities by paediatricians. Studies have shown easy vulnerability of paediatric urinary tract in any acute febrile illness and a miss in diagnosis could have long term consequences like renal scaring with its adverse effects. Bearing these evidence based preludes in view we designed our study to know the prevalence of UTI in Kashmir province.
  
  
  OBJECTIVE
  Aim of the present study was to know the prevalence of UTI in febrile children and to know the sensitivity of different imaging modalities like Renal and Urinary Bladder Ultrasonography (RUS), Voiding Cystourethrography (VCUG) and Dimercaptosuccinic Acid (DMSA) scan in diagnosing UTI.
  
  
  METHODS
  A total of 304 patients, between 2 months to 10 years, with axillary temperature of ≥ 100.4oF (38oC), who did not have a definite source for their fever and who were not on antibiotics were included in the study. Detailed history and through clinical examination was done to rule out any potential or definite focus of infection as per the predesigned proforma. Routine urine examination with culture and sensitivity, followed by RUS and VCUG was done in all patients where routine urine examination was suggestive of UTI. DMSA was done in only culture proven cases after 6 months to document the renal scarring.
  
  
  RESULTS
  Out of 304 children, 140 were males and 164 were females, UTI was present in 40 patients who had fever without any apparent cause giving a prevalence of 13.2%.Escherichia coli (E. coli)were the commonest isolated organism, followed byKlebsiellaandCitrobacterspecies. Renal and Urinary Bladder Ultrasonography (RUS) detected Vesicoureteral Reflux (VUR) in 25% (10/40) while VCUG showed VUR in 55% (22/40) giving a RUS sensitivity of 45% for detecting VUR. DMSA done only after 6 months in UTI diagnosed patients showed a renal scarring in 25% (10/40) patients.
  
  
  CONCLUSIONS
  Missing a febrile paediatric UTI, can prove a future catastrophe if not timely diagnosed and treated.
authors.affiliation: Professor, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India .
authors.forename: Khursheed Ahmed
authors.initials: KA
authors.lastname: Wani
authors.affiliation: Lecturer Pediatric Nephrology, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India .
authors.forename: Mohd
authors.initials: M
authors.lastname: Ashraf
authors.affiliation: Registrar, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India .
authors.forename: Javaid Ahmed
authors.initials: JA
authors.lastname: Bhat
authors.affiliation: Consultant Pediatrics, Jammu & Kashmir Health Services , Jammu & Kashmir, India .
authors.forename: Nazir Ahmed
authors.initials: NA
authors.lastname: Parry
authors.affiliation: Aastha Multispecialty Hospital , Chakkar, Mandi Himachal Pradesh, India .
authors.forename: Lubna
authors.initials: L
authors.lastname: Shaheen
authors.affiliation: Registrar, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India .
authors.forename: Sartaj Ali
authors.initials: SA
authors.lastname: Bhat
keywords: E.coli; Urine culture; Vesicoureteral reflux; Voiding cystourethrography