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Current Management of Urinary Tract Infection and Vesicoureteral Reflux
- Source :
- Indian journal of pediatrics. 87(8)
- Publication Year :
- 2019
-
Abstract
- Urinary tract infection (UTI) is defined as the growth of a significant number of microorganisms of a single species in the urine, in the presence of symptoms. Symptoms in young children are non-specific such as fever without focus; young infants may manifest with irritability, failure to thrive, jaundice, vomiting and diarrhea. Older children usually have symptoms of cystitis or pyelonephritis. Symptoms of cystitis are dysuria, frequency, new onset incontinence and malodorous urine while symptoms of pyelonephritis are high grade fever, flank pain and vomiting. Rapid urine testing by microscopy for pus cells, dipstick testing for leukocyte esterase and nitrite, and enhanced urinalysis are supportive tests. Urine culture samples should be collected with proper technique and results interpreted for significant growth accordingly. Antibiotic therapy for 7–14 d for complicated UTI and 3–4 d for uncomplicated UTI is adequate. Further evaluation is recommended clinically for bladder-bowel dysfunction and obvious anatomical defects and by imaging for vesicoureteral reflux (VUR), usually by micturating cystourethrography (MCU). Since MCU involves exposure to radiation and urethral catheterization, it is now reserved for children with parenchymal involvement or recurrent UTI. VUR is the backward flow of urine into one or both ureters. Clinical manifestations other than UTI include incidental diagnosis on antenatal ultrasonography. Reflux nephropathy, the renal scarring associated with VUR may manifest clinically as hypertension, proteinuria and renal failure. The management of VUR is primarily with antibiotic prophylaxis. Anatomical correction is indicated in case of breakthrough febrile UTI. No intervention has been shown to reduce renal scarring.
- Subjects :
- medicine.medical_specialty
Urinalysis
Adolescent
Fever
Urinary system
Urology
urologic and male genital diseases
Vesicoureteral reflux
03 medical and health sciences
0302 clinical medicine
Pregnancy
030225 pediatrics
medicine
Dysuria
Humans
Antibiotic prophylaxis
Child
Reflux nephropathy
Vesico-Ureteral Reflux
Proteinuria
medicine.diagnostic_test
Pyelonephritis
business.industry
Infant
medicine.disease
female genital diseases and pregnancy complications
Leukocyte esterase
Child, Preschool
Pediatrics, Perinatology and Child Health
Urinary Tract Infections
Female
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 09737693
- Volume :
- 87
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Indian journal of pediatrics
- Accession number :
- edsair.doi.dedup.....c56a68aa08b817e0e516908a6d4f815e