A single-center study on the effectiveness of abdominal ultrasonography in first pediatric febrile urinary tract infection

Abstract

Background and Purpose: Most guidelines for pediatric febrile urinary tract infection recommend abdominal ultrasonography, and management varies depending on the presence of renal and bladder abnormalities. We evaluated the association of abdominal ultrasonographic findings with vesicoureteral reflux and renal scarring in pediatric febrile urinary tract infections. Methods: Of 235 children aged ≤15 years admitted to our hospital between January 2015 and October 2023 with a first episode of febrile urinary tract infection, we retrospectively evaluated 233 patients who underwent abdominal ultrasonography. Results: Ninety-seven patients had abnormal findings on abdominal ultrasonography. However, there were no statistically significant differences in the association between abnormal findings and vesicoureteral reflux in either univariate or multivariate analysis. No significant differences were found for the presence or absence of abnormal ultrasonographic findings other than hydronephrosis (i.e., ureteral dilatation, ureteral mass, and hypoplastic kidney), however the only significant correlation was found between vesicoureteral reflux and bacteria other than Escherichia coli. The association with renal scarring was also examined in 202 patients who underwent dimercaptosuccinic acid renal scintigraphy, and no significant differences were found. Conclusion: Abdominal ultrasonography is a minimally invasive examination; however, further studies are needed to determine whether it is an indicated criterion to avoid cystourethrography or dimercaptosuccinic acid renal scintigraphy.