J Korean Soc Pediatr Nephrol > Volume 13(1); 2009 > Article
J Korean Soc Pediatr Nephrol 2009;13(1): 33-39. doi: https://doi.org/10.3339/jkspn.2009.13.1.33
고열을 동반한3개월 미만 요로 감염 영아에서 척추천자와 배뇨성 방광요도조영술의 필요성
김지희, 이준호
1포천중문의과대학교 분당차병원 소아청소년과
2포천중문의과대학교 분당차병원 소아청소년과
A Necessity for Lumbar Puncture and VCUG in Febrile UTI Infants less than 3 Months of Age
Ji-Hee Kim, Jun-Ho Lee
1Department of Pediatrics, College of Medicine, Pochon Jungmun University Cha Hospital
2Department of Pediatrics, College of Medicine, Pochon Jungmun University Cha Hospital
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Purpose : Our aim is to reduce the rate of lumbar spinal tapping and voiding cystourethrography (VCUG) in febrile urinary tract infection (UTI) infants less than 3 months of age.
Methods : We reviewed the prevalence of UTI, sepsis, meningitis and UTI with bacterial meningitis in febrile infants less than 3 months of age during the period from Jan. 2001 to Jun. 2008. Renal ultrasonography, Technetium-99m dimercaptosuccinic acid (DMSA) renal scan or VCUG were performed in infants with UTI. Infants with UTI were divided into two groups according to the presence of abnormal findings of ultrasonography and DMSA renal scan : group 1-Infants in whom both ultrasonography and DMSA were normal, group 2-Infants in whom ultrasonography or DMSA were abnormal. Prevalence of VUR was compared between the two groups. We followed up the clinical course of patients who had VUR in group 1.
Results : Among 1962 Infants, UTI, sepsis and bacterial meningitis were diagnosed in 620 (31.6%), 63 (3.2%), 8 (0.4%) respectively. Lumbar puncture was performed in 413 (66.6%) infants with UTI and we did not detect a case of bacterial meningitis in association. 348 infants with proven UTI were undergone ultrasonography, DMSA, VCUG. In group 1 with 110 infants (31.6%), the presence of VUR was 4 (3.6%). In group 2 with 238 infants (68.4%), the presence of VUR was 51 (21.4%). Abnormal findings of ultrasonography or DMSA renal scan were closely related with high grade VUR. Most of patients with VUR in group1 had good prognosis.
Conclusion : Lumbar puncture and VCUG are invasive procedures. Therefore we should decide whether to perform lumbar puncture or VCUG in infants less than 3 months. of age with their first febrile UTI.
Key words: Urinary tract infection | Bacterial Meningitis | Voiding cystourethrography
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