Association of urinary tract abnormalities in children with first urinary tract infection

ABSTRACT

Urinary Tract Infections [UTI] may be a variety of presentation of underlying urinary tract abnormalities including vesicoureteral reflex [VUR], obstructive uropathy, urolithiasis, and ureteral duplication. The long-term complications of UTI with these conditions are renal scarring, hypertension, and chronic renal failure. The aim of this study was to determine the incidence of urinary tract anomalies associated with first UTI. We reviewed 158 patients [aged one month to 15 years] who were hospitalized with symptomatic UTI during a 2-year period [2001-2003]. Patients with incomplete investigations were excluded from the study. One hundred twenty six patients [100 girls and 26 boys] were included in the study. Ninety-seven [77%] were under 5 years. Confirmed cases of UTI underwent renal and urinary tract ultrasonography [US], voiding cystourethrography [VCUG],and 99mTc-dimercaptosuccinc acid [DMSA] scan. The most common presentation were fever [83%] and dysuria [48%]. The commonest causative agent was E coli [88%]. VUR was found in 50 [39.6%], 39 girls, and 11 boys. Other urinary tract abnormalities were renal stone in 10 [8%] patients, pelvic ureteric junction obstruction in 8 [6.3%], neurogenic bladder in two boys and one girl, double collecting system in 2 girls, posterior urethral valves in two boys and ureterocele in one girl, respectively. Forty percent of patients had VUR and 20% had other associated abnormalities in urinary tract. We recommend that US, VCUG and DMSA scan should be routinely performed on all patients after the first UTI