The role of ultrasound in investigating paediatric urinary tract infections for urinary structural defects at Chris Hani Baragwanath Academic Hospital
Article Sidebar
Main Article Content
Abstract
Background. The number of paediatric genitourinary ultrasounds performed with an indication of urinary tract infection (UTI) is abundant. However, there are minimal data regarding whether UTI is an appropriate indication for determining whether urinary structural defects (USD) will be identified.
Objectives. To quantify structural urinary tract defects identified in the paediatric population presenting with a UTI. Furthermore, diagnoses will be assessed according to sex and age group.
Methods. A retrospective review of 180 cases of paediatric ultrasounds was done, with an indication of UTI. Data were collected at Chris Hani Baragwanath Academic Hospital (CHBAH) from March 2022 to November 2022. USDs, as well as the normal ultrasounds, were identified and quantified.
Results. Twelve different structural urinary tract defects were found in this study. The most common being hydroureteronephrosis. Duplex collecting system and pelviureteric junction obstruction were the second most common. USDs were more common in males than females, but the incidence was equal in all age groups.
Conclusion. There was no statistical relationship between a diagnosis of UTI in children and the presence of a USD. Furthermore, once a urinary structural tract defect was identified, there was no statistical relationship between the diagnosis and age or sex.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The SAJCH is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
How to Cite
References
1. Osuch E, Marais A. Urinary tract infections in children. S Afr Fam Pract 2018;60(1):35-40. https://doi:10.4102/safp.v60i1.4782
2. Lentz B, Fong T, Rhyne R, et al. A systematic review of the cost-effectiveness of ultrasound in emergency care settings. Ultrasound J 2021;13(1):16. https:// doi:10.1186/s13089-021-00216-8
3. Marks SD, Gordon I, Tullus K. Imaging in childhood urinary tract infections: Time to reduce investigations. Pediatr Nephrol 2008;23(1):9-17. https:// doi:10.1007/s00467-007-0552-9
4. Pellegrino C, Capitanucci ML, Forlini V, et al. Posterior urethral valves: Role of prenatal diagnosis and long-term management of bladder function; a single- center point of view and review of literature. Front Pediatr 2023;10(22):1057092. https://doi:10.3389/fped.2022.1057092
5. Jackson L, Woodward M, Coward RJ. The molecular biology of pelvi-ureteric junction obstruction. Pediatr Nephrol 2018;33(4):553-571. https://doi. org/10.1007/s00467-017-3629-0
6. Swerkersson S, Jodal U, Sixt R, et al. Relationship among vesicoureteral reflux, urinary tract infection and renal damage in children. J Urol 2007;178(2):647- 651. https://doi.org/10.1016/j.juro.2007.04.004
7. Keuler N, Johnson Y, Coetzee R. Treating urinary tract infections in public sector primary healthcare facilities in Cape Town, South Africa: A pharmaceutical perspective. S Afr Med J 2022;112(7):487-493. https://doi. org/10.7196/samj.2022.v112i7.16258
8. Kilborn T, Moodley H, Brink A, Nourse P. A case-based approach to UTI imaging – making sense of the guidelines. S Afr J Radiol 2015;19(2):a877. https://doi.org/10.4102/sajr.v19i2.877
9. Andronikou S, Welman C, Kader E, et al. Imaging strategy for South African children with their first proven UTI in a tertiary hospital setting. S Afr J Radiol 2001;5(1):4-8. https://doi.org/10.4102/sajr.v5i1.1484
10. Rasouly HM, Lu W. Lower urinary tract development and disease. Interdiscip Rev Syst Biol Med 2013;5(3):307-342. https://doi.org/10.1002/wsbm.1212
11. Visuri S, Jahnukainen T, Taskinen S. Prenatal complicated duplex collecting
system and ureterocele – important risk factors for urinary tract infection.
J Pediatr Surg 2018;53(4):813-817. https://doi.org/10.1016/j.jpedsurg.2017.05.007 12. Didier RA, Chow JS, Kwatra NS, et al. The duplicated collecting system of the urinary tract: Embryology, imaging appearances and clinical considerations. Pediatr Radiol 2017;47(11):1526-1538. https://doi.org/10.1007/s00247-017-
3904-z
13. Krajewski W, Wojciechowska J, Dembowski J, et al. Hydronephrosis in the course of ureteropelvic junction obstruction: An underestimated problem? Current opinions on the pathogenesis, diagnosis and treatment. Adv Clin Exp Med 2017;26(5):857-864. https://doi.org/10.17219/acem/59509
14. Cleper R, Krause I, Eisenstein B, et al. Prevalence of vesicoureteral reflux in neonatal urinary tract infection. Clin Pediatr 2004;43(7):619-625. https://doi. org/10.1177/000992280404300706
15. Berrocal T, López-Pereira P, Arjonilla A, et al. Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics 2002;22(5):1139-1164. https://doi.org/10.1148/ radiographics.22.5.g02se101139
16. Kessler RM, Altman DH. Real-time sonographic detection of vesicoureteral reflux in children. Am J Roentgenol 1982;138(6):1033-1036. https://doi. org/10.1016/s0022-5347(17)53395-9
17. Paladini D, Volpe P. Ultrasound of Congenital Fetal Anomalies: Differential Diagnosis and Prognostic Indicators. Boca Raton: Taylor & Francis, 2014. https://doi.org/10.1201/9781003048268
18. Cordeiro LPV, Carvalho ACM, Silva IM, et al. Cystic partially differentiated nephroblastoma: A rare pediatric renal tumor-case report. Radiol Case Rep 2020;15(8):1133-1137. https://doi.org/10.1016/j.radcr.2020.05.001
19. Johnin K, Kobayashi K, Tsuru T, et al. Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children. Int J Urol 2018;26(2):160-171. https://doi.org/10.1111/iju.13881
20. Ditchfield MR, Nadel HR. The DMSA scan in paediatric urinary tract infection. Australas Radiol 1998;42(4):318-320. https://doi.org/10.1111/j.1440-1673.1998. tb00530.x