Urinary infection in Pediatrics: Relationship between clinical, paraclinical and renal gammagraphy
Infección urinaria en Pediatría: Relación entre clínica, paraclínica y gamagrafía renal
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Objective: to describe the relationship between clinical findings, laboratory and static renal gammagraphy (GR-DMSA) in pediatric patients hospitalized for urinary tract infection (UTI) at the Hospital de San José. Materials and methods: descriptive, cross-sectional study. We included 130 patients between three months and 14 years of age. Information was taken from the medical records reviewing the variables: age, gender, fever, general condition, leukocytosis in hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein, hyposthenuria, nitrites and leukocyte esterases (EL) in uroanalysis, comparing each one of them with the result of the GR-DMSA. Results: 76% of the patients showed pyelonephritis with GR-DMSA. 87.7% of these were infants and preschoolers and 72% were girls. Bivariate analyzes were performed using as an association measure the relative risk (RR) and as a measure of the accuracy the confidence interval (CI) of 95%. It was found that patients who present with leukocytosis, increased ESR and EL positive are 1.81 times more likely to present pyelonephritis. Conclusions: if a patient presents with leukocytosis, elevated ESR and positive EL, it is not recommended to perform GR-DMSA, given that the probability of having pyelonephritis is 81%. The sensitivity of these laboratories is 76% and the specificity of 58%, compared to the GR-DMSA. Abbreviations: GR-DMSA, renal gammagraphy with dimercaptosuccinic acid; UTI, urinary tract infection; ESR, erythrocyte sedimentation rate; EL, leukocyte esterases; RR, relative risk; IC, confidence interval.
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