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pyelonephritis acute in children

Jun Aoyagi, Takahiro Kanai, Jun Odaka, Takane Ito, Takashi Saito, Hiroyuki Betsui, Rieko Furukawa, Waka Nakata, Takanori Yamagata
The utility of non-enhanced magnetic resonance imaging (MRI) has not been examined extensively for diagnosing acute pyelonephritis (APN) in children. The aims of this study were to compare non-enhanced MRI with technetium-99 m dimercaptosuccinic acid (99m Tc-DMSA) renal scintigraphy in detecting APN. Six boys and one girl with temperature ≥38°C and positive urine culture received both non-enhanced MRI with whole body diffusion-weighted imaging (DWI) and99m Tc-DMSA scintigraphy ≤7 days from the fever onset...
February 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Sherein Abdelhamid Shalaby, Nesrein Mosad Handoka, Rasha Emad Amin
Introduction: In humans, vitamin D has been shown to play a role in infectious diseases, but its association with acquisition and a complicated course of febrile urinary tract infections (UTIs) has not been investigated. We aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D3 ) levels and the risk of first time febrile UTI in children. Material and methods: This prospective case-control study included 50 children with first febrile UTI, with no risk factors for UTI, and 50 age- and sex-matched healthy siblings as controls...
January 2018: Archives of Medical Science: AMS
A V Pirogov, V V Sizonov, M I Kogan
AIM: Recent advances in the field of minimally invasive surgical technologies in children and adolescents have led to the development of vesicoscopic (transvesical, pneumoscopic) access (VA). Current limitations in using VA emphasize the need for further studies investigating surgical options for the management of various pathological conditions of the bladder and ureterovesical junction, the features of surgical techniques and the course of the early postoperative period when used in pediatric urological practice...
December 2017: Urologii︠a︡
Jung Won Lee, Sun Mi Her, Ji Hong Kim, Keum Hwa Lee, Michael Eisenhut, Se Jin Park, Jae Il Shin
BACKGROUND: D-dimer, as well as other biomarkers related to coagulation, is significantly increased during severe bacterial infection and sepsis. The aim of this study was to evaluate the usefulness of serum D-dimer as a biological marker in diagnosing acute pyelonephritis (APN) and in predicting vesicoureteric reflux (VUR) in infants with urinary tract infection (UTI). METHODS: We retrospectively analyzed the data of 177 young infants (<2 years) with febrile UTI between 2005 and 2014, grouped as APN and lower UTI groups...
January 6, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Vikas R Dharnidharka, Neil Vyas, Joseph P Gaut, Leslie Walther, S Paul Hmiel
BACKGROUND: Surveillance biopsies (SBs) are performed in some pediatric kidney transplant programs, based on data obtained in earlier immunosuppressive eras that the treatment of subclinical acute rejection results in better graft survival. The benefit of SBs for patients on modern immunosuppression regimens is unclear. We have therefore evaluated the clinical utility of SBs in a population of children receiving a kidney transplant. METHODS: We have performed SBs at 3, 6 and 12 months post-transplantation as standard of care at our institution since 2013 in patients on a regimen of rabbit anti-thymocyte globulin, tacrolimus, mycophenolate and rapid steroid taper (RST; steroids maintained in some exceptions)...
December 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Seyed Mohammad Abedi, Hamid Mohammadjafari, Alireza Rafiei, Sara Bazi, Pooneh Yazdani
Objective: Urinary tract infection occurs in 1.8-6.6% of children under 6 years old. The aim of this study was to assess the urinary concentrations of matrix metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1), in children with acute pyelonephritis (APN) and the potential to develop renal scarring. Material and methods: Children who had experienced an episode of APN were divided into 2 groups. Group 1 included children with APN who exhibited scarring and group 2 included children with APN who had a normal99m Technetium dimercaptosuccinic acid scan...
December 2017: Turkish Journal of Urology
David S Hains, Harris L Cohen, M Beth McCarville, Ellen E Ellison, Amy Huffman, Stacey Glass, Aslam H Qureshi, Keith R Pierce, Ashlyn L Cahill, Ashley Dixon, Noel Delos Santos
Introduction: Vesicoureteral reflux is a common disorder in children but can result in kidney scarring following acute pyelonephritis. The gold standard diagnostic to detect renal scars in children is (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy. DMSA has a number of limitations including radiation exposure, need for sedation, and radiotracer supply shortages. Contrast-enhanced ultrasound (CEUS) is a technique whereby biocompatible microspheres of inert gas are administered i.v...
May 2017: KI Reports
Meltem Polat, Soner Sertan Kara
Background: The rise in community-acquired urinary tract infections (UTIs) with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli strains raises the question of how to treat these infections effectively in pediatric outpatients. Amikacin has shown promising in vitro activity against ESBL-producing urinary isolates of E. coli ; however, clinical data are limited. Objective: To investigate the clinical and microbiological outcomes of community-acquired lower UTIs caused by ESBL-producing E...
2017: Infection and Drug Resistance
Alireza Rafiei, Hamid Mohammadjafari, Ayat Ahifar, Abbas Alipour, Araz Mohammad Mirabi
Aim: We assessed the urinary and serum levels of IL-32 in pediatric patients with acute pyelonephritis (APN) with and without renal scarring. Results: We enrolled children aged 2 months to 16 years with APN. Dimercaptosuccinic acid scans and ultrasonography studies were ordered for all patients, and a voiding. A total of 86 children (aged 57 ± 39 months, 74 [86%] female) were enrolled in this study. Group 1 was composed of 19 (16 female) patients, group 2 of 38 (35 female) patients and group 3 of 29 (23 female) patients...
November 2017: Future Science OA
Jun Ho Lee
BACKGROUND: We investigated whether the C-reactive protein (CRP) level, urine electrolytes, and urine sodium-potassium ratio (uNa/K) could be useful markers for discriminating children with culture negative pyelonephritis (CNP) from children with suspected febrile urinary tract infection (fUTI) and negative urine culture results. METHODS: We examined 264 children experiencing their first fUTI consecutively admitted to our hospital between January 2011 and October 2014...
October 25, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Nimisha Arora, Abhijeet Saha, Manpreet Kaur
Tuberculous pyelonephritis is rare in children; three case reports are presented. Case 1 was an 11-year-old girl with a previous history of pulmonary tuberculosis who presented with flank pain and fever for 10 days. An ultrasound suggested focal pyelonephritis, and a contrast-enhanced computed tomography (CECT) scan demonstrated acute focal pyelonephritis and a perinephric collection. Mycobacterium tuberculosis was cultured in the urine. She responded well to anti-tuberculous treatment (ATT). Case 2 was a 13-year-old boy who presented with fever, haematuria, burning micturition, proteinuria (3+) and cervical lymphadenopathy...
November 2017: Paediatrics and International Child Health
Almontaser Hussein, Khaled Saad, Eman Askar, Asmaa M Zahran, Hekma Farghaly, Kotb Metwalley, Ahmad A Elderwy
AIM: We studied the functional polymorphisms of intercellular adhesion molecule-1 (ICAM-1) and toll-like receptor-4 (TLR-4) genes and risk of acute pyelonephritis (APN) in children attending Assiut University Children's Hospitals, Egypt, from 2011 to 2015. METHODS: Urinary tract infections (UTIs) were diagnosed in 380 children: 98 had APN and 282 had lower UTIs. Four single-nucleotide polymorphisms in ICAM-1 and TLR-4 genes were genotyped in all subjects: ICAM-1 rs1799969 Gly241Arg, ICAM-1 rs5498 Glu469Lys, TLR-4 rs4896791 Thr399Ile and TLR-4 rs4896790 Asp299Gly...
October 13, 2017: Acta Paediatrica
Jean Daniel Delbet, Mathie Lorrot, Tim Ulinski
This review focuses on the treatment of urinary tract infections (UTI) in children and in particular its recent changes. Areas covered: Acute pyelonephritis, acute cystitis and asymptomatic bacteriuria or asymptomatic infections have to be clearly distinguished. Prompt treatment is required in pyelonephritis and cystitis, but not in asymptomatic bacteriuria or infection, in order to avoid selection of more virulent strains. This concept should be considered even in immunocompromised or bedridden children. In case of pyelonephritis, there should be no delay in beginning the antibiotic treatment in order to decrease the risk of long term complication, such as renal scars...
October 2017: Expert Opinion on Pharmacotherapy
Almontaser Hussein, Eman Askar, Ahlam Badawy, Khaled Saad, Asmaa Zahran, Ahmad A Elderwy
BACKGROUND: Acute pyelonephritis is associated with renal scarring in up to 30% of patients. Renal scarring may cause significant long-term morbidity. The pathogenesis of acute pyelonephritis remains unclear, although it involves interaction among uroepithelium, the immune system cells, and the locally produced cytokines. That some UTI-prone children develop acute pyelonephritis, and eventually renal parenchymal scarring, suggests a genetic role. Interleukin-6, interleukin-8, chemokine receptor-1 (CXCR1), and tumor necrosis factor-alpha (TNFα), the key regulators of the host immune responses, are proteins whose secretion is controlled by genes...
July 3, 2017: Journal of Pediatric Urology
Tej K Mattoo, Steven J Skoog, Lisa Gravens-Mueller, Russell W Chesney, Alejandro Hoberman, Ranjiv Mathews, Marva Moxey-Mims, Anastasia Ivanova, Saul P Greenfield, Myra A Carpenter
INTRODUCTION: Technetium-99m dimercaptosuccinic acid (DMSA) renal scans are used in the diagnosis of renal scarring. In the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial that randomized 607 children, DMSA renal scans were used for evaluating the presence and the severity of renal scarring. OBJECTIVE: The aim was to determine interobserver variability in reporting of DMSA renal scans in the RIVUR trial. STUDY DESIGN: We compared DMSA renal scan reports for renal scarring and acute pyelonephritis from all non-reference local radiologists (ALRs) at study sites with adjudicated as well as non-adjudicated reports from two reference radiologists (RRs) of the RIVUR trial...
December 2017: Journal of Pediatric Urology
Makoto Mizutani, Shunji Hasegawa, Takeshi Matsushige, Naoki Ohta, Setsuaki Kittaka, Madoka Hoshide, Takeshi Kusuda, Kazumasa Takahashi, Kiyoshi Ichihara, Shouichi Ohga
BACKGROUND: Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. METHODS: Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n=17) or APN (n=21) who underwent ultrasonography and/or CT were enrolled...
July 3, 2017: Cytokine
Victor Soulier, Aure Lien Scalabre, Manuel Lopez, Chi-Ying Li, Sodara Thach, Sophie Vermersch, Franc Ois Varlet
PURPOSE: Vesico-ureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Surgery is an important part of its management. Laparoscopic ureteric reimplantation using the Lich-Gregoir technique is an option for VUR. The aim of this study is to assess short- and medium-term outcomes of this approach. MATERIALS AND METHODS: This is a retrospective study including all children with VUR treated by laparoscopic extravesical ureteral reimplantation with the Lich-Gregoir technique in University Hospital of Saint-Etienne from August 2007 to May 2016...
November 2017: World Journal of Urology
Ian K Hewitt, Marco Pennesi, William Morello, Luca Ronfani, Giovanni Montini
CONTEXT: Acute pyelonephritis may result in renal scarring. Recent prospective studies have shown a small benefit of antibiotic prophylaxis in preventing symptomatic and febrile urinary tract infections (UTIs), while being underpowered to detect any influence in prevention of renal damage. OBJECTIVES: Review of the literature and a meta-analysis to evaluate the effect of antibiotic prophylaxis on UTI-related renal scarring. DATA SOURCES: Medline, Embase, and Cochrane Controlled Trials Register electronic databases were searched for studies published in any language and bibliographies of identified prospective randomized controlled trials (RCTs) performed and published between 1946 and August 2016...
May 2017: Pediatrics
Ewa Pietrzak-Stelasiak, Małgorzata Bieńkiewicz, Wojciech Woźnicki, Krystyna Bubińska, Magdalena Kowalewska-Pietrzak, Anna Płachcińska, Jacek Kuśmierek
BACKGROUND: Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study...
2017: Nuclear Medicine Review. Central & Eastern Europe
Elizabeth E Dawson-Hahn, Sharon Mickan, Igho Onakpoya, Nia Roberts, Matthew Kronman, Chris C Butler, Matthew J Thompson
Purpose: To summarize the evidence comparing the effectiveness of short and long courses of oral antibiotics for infections treated in outpatient settings. Methods: We identified systematic reviews of randomized controlled trials for children and adults with bacterial infections treated in outpatient settings from Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews and The Database of Review of Effects. Data were extracted on the primary outcome of clinical resolution and secondary outcomes...
September 1, 2017: Family Practice
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