Objective
Urinary tract infection (UTI) needs to be considered when an infant is evaluated for fever in the first few months of life.
An accurate initial diagnosis is important in this setting, as young infants with UTI are at risk for concomitant bacteremia and renal scarring development.
The aim of our study was to find the incidence of pyelonephritis in infants between 0-3 months with UTI and if there is any laboratory marker to distinguish between upper and lower UTI.
Methods
The study was performed on 100 infants, 0-3 months with UTI. CBC, CRP, ESR, renal function and blood culture were checked. All the infants underwent renal US and DMSA scan during the first month after the diagnosis of UTI.
Results
On the base of DMSA scan acute pyelonephritis was diagnosed only in 19% of infants with positive urine culture.
The WBC, CRP and ESR results in infants with pyelonephritis didn't differ from the results of the same markers in the infants without DMSA scan signs of pyelonephritis.
The temperature was significantly higher in the group of patients with acute pyelonephritis.
Conclusion
Based on our study results, the frequency of acute pyelonephritis in infants aged 0 to 3 months is lower than the frequency found in older children.
The laboratory markers we used can't help to differentiates between upper and lower UTI.
It can be supposed that these infants needs only kidney ultrasound as a follow-up and if it is normal no further investigation should be recommended.
