Background: Management of urinary tract infection (UTI) in children remains important. It may be the first sign for a possible underlying congenital abnormalities for the kidney and urinary tract (CAKUT). This study examined whether performing renal and bladder ultrasonography (RBUS) only for children who have a pathogen other than E. coli during their first urinary tract infection (UTI), or who experience UTI recurrence, would result in more missed diagnoses of kidney anomalies.
Methods: Patients aged between 2 months and 2 years who were seen in a tertiary pediatric hospital during a 2-year period and diagnosed with UTI were included. RBUS and voiding cystourethrography (VCUG) were performed according to American Academy of Pediatrics (AAP) guidelines. Afterwards, we looked back and evaluated how often we found kidney problems when we only did a RBUS on patients who had an atypical cause of their first UTI or who had multiple UTIs.
Results: One hundred and seventy-eight patients who were followed up with UTI were included in this study. The isolated pathogen was E. coli in 104 cases (58.4 %) and atypical in 74 cases (41.6 %). VCUG was conducted on 40 patients, and vesicoureteral reflux (VUR) was discovered in 16 cases and ureteropelvic junction obstruction (UPJO) was discovered in 1 case. A different diagnostic approach that required the presence of an atypical pathogen at the first UTI or a fUTI recurrence to perform the RBUS would have missed just two severe kidney anomalies. It was observed that there could be a decrease of 40.4 % in RBUS and at least 20 % in VCUG.
Conclusions: A diagnostic approach that necessitates the presence of an abnormal pathogen during the initial UTI or a second UTI episode for the RBUS to be carried out would lead to fewer negative ultrasounds with minimal risk of overlooking kidney anomalies.
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http://dx.doi.org/10.1016/j.jpurol.2023.10.026 | DOI Listing |
Ann Clin Microbiol Antimicrob
January 2025
Microbiology and Immunology Department, Faculty of Pharmacy, Mansoura University, Mansoura, 35516, Egypt.
Proteus mirabilis (P. mirabilis) is one of the most important causative pathogens associated with complicated urinary tract infections with a 20% incidence. For epidemiological determinations, several phenotypic and molecular typing methods have been implicated.
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January 2025
Department of Obstetrics and Gynecology, Firoozgar Clinical Research and Development Center (FCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background: Complete Cytoreduction (CC) in ovarian cancer (OC) has been associated with better outcomes. Outcomes after CC have a multifactorial and interrelated cause that may not be predictable by conventional statistical methods. Artificial intelligence (AI) may be more accurate in predicting outcomes.
View Article and Find Full Text PDFBMC Urol
January 2025
Department of Urology, Hama National Hospital, Hama, Syria.
Background: Urethral diverticulum is a sac-like dilation that extends from the urethral lumen and is connected to it. It can either be congenital or acquired, with the latter being more common. The development of calculi is rare in such patients.
View Article and Find Full Text PDFBMC Urol
January 2025
Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, China.
Background: In male patients, benign prostate hyperplasia (BPH) and overactive bladder (OAB) secondary to BPH are the primary causes of Lower Urinary Tract Symptoms (LUTS). Recent clinical studies have reported an increased risk of LUTS, particularly severe LUTS conditions, in male asthmatic patients. However, the potential link and mechanism remain unclear.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Nephrology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, 920-0293, Ishikawa, Japan.
To decrease the number of chronic kidney disease (CKD), early diagnosis of diabetic kidney disease is required. We performed invariant information clustering (IIC)-based clustering on glomerular images obtained from nephrectomized kidneys of patients with and without diabetes. We also used visualizing techniques (gradient-weighted class activation mapping (Grad-CAM) and generative adversarial networks (GAN)) to identify the novel and early pathological changes on light microscopy in diabetic nephropathy.
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