IMAGING RESEARCH AFTER THE FIRST FEBRILE URINARY TRACT INFECTION: WHAT IS THE IDEAL PROTOCOL?

Introduction: The approach and workup of a first febrile urinary tract infection (UTI) in children remains controversial. The NICE does not recommend additional investigation if there is a good response to antibiotic therapy and if UTI is not atypical and/or recurrent. Objective: To analyze the predictive value of each imaging technique in detection of uropathy and/or renal scars in children. Material: This is a retrospective study based on data of clinical reports of children under 24 months old, who were admitted with diagnosis of febrile UTI. Data was divided in groups: A – normal micturating cystourethrogram (MCUG) and dimercapto-succinic-acid (DMSA) scan; B – abnormal MCUG and/or DMSA. Results and conclusions: A total of 115 cases were found. Group A includes 84 children (73%) and group B contains 31 (27%). Ultrasound is a low sensitivity and specificity test in detection of renal lesions. Even with increased levels of severity of vesicoureteral reflux (VUR), DMSA did not expand detection and/or severity of lesions (p