ABSTRACT
Urinary tract infection [UTI] is one of the most common bacterial infections in children. Non-specific symptomatology in infants and young children makes the clinical differentiation between lower UTI and acute pyelonephritis [APN] difficult. The aim of this study was to assess the correlation between APN findings of renal cortical scintigraphy and selected clinical/laboratory findings of febrile UTI in infants and children admitted at our center. A prospective study was conducted in 83 infants and young children aged I month -8 years hospitalized with febrile UTI in nephrology ward of Abuzar children's hospital. Within the first 5 days after admission, Tc-99m DMSA renal scintigraphy, ultrasonography [US], voiding cystoureterography [VCUG], erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], hemoglobin [Hb], white blood cell count [WBC] and urine analyses were performed. Mean age was 24.3 months with 82% [68] girls. DMSA scintigraphy showed APN findings in 45/83[54.2%] patients, with a mean age of 30.2 months, including 9 males [20%] and 36 [80%] females. There were statistically significant correlations between the APN findings of DMSA scintigraphy and the fever duration, body temperature, lucocytosis, anemia, proteinurea, CRP levels and ESR [p<0.05]. Vesicoureteral reflux was found in 20.5% of patients with no statistically significant correlations to the APN findings of DMSA scintigraphy. Although initial DMSA renal scintigraphy is useful for determination and localization of kidney involvement during febrile UTI, some clinical and paraclinical findings can predict the scintigraphycal findings of kidney involvement that need further evaluations for portable complications in the future