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Risk factors in the development of early technetium-99m dimercaptosuccinic acid renal scintigraphy lesions during first urinary tract infection in children
Article first published online: 2 JAN 2007
DOI: 10.1111/j.1651-2227.2003.tb00463.x
1651-2227/asset/cover.gif?v=1&s=587e9b334e01b5328ef56d6ab5552a09f530e683 "Acta Paediatrica")
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How to Cite
Fernández-Menéndez, J., Málaga, S., Matesanz, J., Solís, G., Alonso, S. and Pérez-Méndez, C. (2003), Risk factors in the development of early technetium-99m dimercaptosuccinic acid renal scintigraphy lesions during first urinary tract infection in children. Acta Paediatrica, 92: 21–26. doi: 10.1111/j.1651-2227.2003.tb00463.x
Publication History
- Issue published online: 2 JAN 2007
- Article first published online: 2 JAN 2007
- Received Feb. 15, 2002; revision received July 9, 2002; accepted Sept. 17, 2002
- Abstract
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Keywords:
- Acute pyelonephritis;
- DMSA scintigraphy;
- urinary tract infection;
- vesicoureteral reflux
Aim: To establish the variables that correlate with uptake defects in dimercaptosuccinic acid (DMSA) scintigraphy performed in the acute phase of a first episode of urinary tract infection (UTI). Methods: A prospective observational study was conducted in a cohort of 158 consecutive children with a first episode of symptomatic UTI. The therapeutic delay time (TDT) was recorded. DMSA scintigraphy was performed in all children and voiding cystourethrography in 150 of them. Results: 85% of the patients were younger than 2 y. Mean TDT was 33.5 h. The aetiological agent was Escherichia coli in 140 children. DMSA scintigraphy was normal in 81. Vesicoureteric reflux was detected in 33. After a multivariate logistic regression analysis the following variables were retained in the final model: TDT ≥48 h, growth of bacteria other than E. coli, percentage of polymorphonuclear cells ≥60% and C-reactive protein ≥30 mg−1.
Conclusion: TDT ≥48 h, bacteria other than E. coli, percentage of polymorphonuclear cells ≥60% and CRP ≥30 mg−1 influence the findings detected in the DMSA scintigraphy performed in the acute phase of a first episode of UTI.