Boris Ajdinovic
Military Medical Academy, Serbia
Title: Different guidelines for imaging in children with febrile urinary tract infections
Biography
Biography: Boris Ajdinovic
Abstract
The best approach to imaging of a child with febrile urinary tract infection (UTI) is highly debatable. Renal ultrasound (US), a voiding cystourethrogram (VCUG) and renal dimercaptosuccinic acid (DMSA) scintigraphy are the most commonly used imaging methods. UTI are common in childhood, and most children recover without complications. Use of imaging to check for abnormalities or complications therefore needs to be targeted carefully. Because a renal US is noninvasive and may give supplemental information about a child’s risk for lower tract infections by showing bladder abnormalities, a renal US should be initially ordered study in children with UTI. In 2011. The American Academy of Pediatric (AAP) recommended that renal US be performed after first febrile UTI but that VCUG should be obtained only if there are renal abnormalities, or after second febrile UTI. Significant controversy surrounded this recommendation and many pediatric urologists disagreed with the APP guidelines (Logvinenko T. et al., 2015., Bush NC et al., 2015.). Obtaining a VCUG with first UTI in all male patients, females younger than 3 years, children clinically suspected of having pyelonephritis, and those with US abnormalities has been recommended (”bottom-up” approach).