Abstract

LLERA, Julián; CARUSO, Martín  and  RUIZ, Eduardo. Evaluación de las ecografías renales prenatal y posinfección, en niños pequeños con un primer episodio de infección urinaria. Arch. argent. pediatr. [online]. 2006, vol.104, n.4, pp.328-332. ISSN 0325-0075.

Introduction.The use of imaging methods is a usual practice after the first urinary tract infection (UTI). The use of post-infection renal ultrasound (PIRU) is questioned by some authors, in view of the nephrourological data provided by the even more frequent prenatal ultrasound. Objective. To evaluate the findings and use fullness of PIRU in infants with a first episode of UTI with history of a normal prenatal ultrasound in the last trimester of pregnancy. Population, material and methods. All infants aged 1 to 18 months hospitalized with a first episode of UTI were evaluated. All had at least one normal prenatal ultrasound in the last trimester of pregnancy and were evaluated by ultrasound in the first 48 hs after the diagnosis. Results. 43 patients were assessed, with a median age of 5.5 months. The PIRU was normal in 38 patients (88.4%), showed a mild pielic dilatation in 4 (9.3%), and was clearly abnormal in only 1 (2.3%). 28 cystographies were made (65%), 9 (32%) showed vesicoureteric reflux (VUR). The 5 patients with grade I or II VUR had normal PIRU. Among the remaining 4 patients with grade II and IV VUR, three had slight dilation in the PIRU and the remaining one had an abnormal PIRU. One patient with slight dilation in the postinfectious sonography had a normal cystography. The PIRU showed a 44% sensitivity for the detection of VUR. Conclusion. In patients from 1 to 18 months of age with a first urinary tract infection and at least one prenatal ultrasound in the last trimester of pregnancy without nephrourologic pathology, the PIRU did not contribute with information that modified medical conduct. All patients with urological abnormalities would have been detected by cystourethrography.

Keywords : Urinary tract infection; Infants; Prenatal ultrasound.

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