IMAGING PROFILE OF CHILDREN BIRTH TO 12 YEARS PRESENTING WITH FIRST URINARY TRACT INFECTION (UTI) AT A TERTIARY CARE HOSPITAL

Imaging of the urinary tract is recommended for all children with UTI. The aim of these investigations is to identify patients at risk of renal damage, mainly those below 5years of age, with vesicoureteric reflux (VUR) or urinary tract obstruction. This study was designed and conducted in the department of Pediatrics and department of Radiodiagnosis, BVDU Medical college hospital, Pune during the period from July 2009 to August 2011 to do imaging studies as per protocol of investigations suggested by the Indian Pediatric Nephrology Group of children from birth to 12 years of age presenting with their first culture positive UTI who attended our tertiary care centre. Abnormal USG was found in 40.3% cases and helped to identify hydroureteronephrosis (HUN) and calculi. Micturating cystourethrography (MCU) examination was abnormal in 31.1% cases. Of which, 22.2% patients had VUR suggesting that VUR is common in culture positive UTI, thus stressing the need of MCU in patients of culture positive UTI. DMSA scintigraphy (DMSA) showed scar in 56% of total cases examined indicating need for doing DMSA whenever indicated and for prognostication. One single imaging modality is not sufficient to evaluate children with UTI.