The value of urinalysis in differentiating acute pyelnephritis from lower urinary tract infection in febrile infants

Daniel Landau, Mary Ellen Turner, Jennifer Brennan, Massoud Majd

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

There is an ongoing debate on the best way to screen febrile infants for urinary tract infection. We examined the urinanalysis (UA) findings on admission among infants less than 16 weeks old, with and without acute pyelonephritis (APN), as defined by the dimercaptosuccinic acid (DMSA) renal scan findings, performed during a 57-month period. Forty-nine cases with a positive DMSA scan were compared with 79 negative study cases. A negative UA for leukocytes (<5 white blood cells/high power field) was found in 4 of 49 (8.1%) cases with APN by DMSA, and in 34 of 79 (43%) cases with a negative DMSA (odds ratio 10.88 (95% confidence interval, 2.31 to 70.3; P < 0.001)). Three of the 4 infants not suspected to have APN by their UA findings would have been admitted for a full sepsis workup based on their clinical presentation and/or their laboratory findings on admission. We conclude that a fresh UA may be a sufficient screening method for the exclusion of APN in infants assessed for fever of no obvious origin.

Original languageEnglish
Pages (from-to)777-781
Number of pages5
JournalPediatric Infectious Disease Journal
Volume13
Issue number9
DOIs
StatePublished - 1 Jan 1994
Externally publishedYes

Keywords

  • Dimercaptosuccinic acid renal scan
  • Febrile infants
  • Urinalysis
  • Urinary tract infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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