Clinical Significance of Pyuria in Pediatric Patients with Febrile Urinary Tract Infection

Choi, Lim; Cho, Sea-Eun; Yim, Hyung-Eun; Yoo, Kee-Hwan; Hong, Young-Sook; Lee, Joo-Won

doi:2011.15.1.66

J Korean Soc Pediatr Nephrol > Volume 15(1); 2011 > Article

J Korean Soc Pediatr Nephrol 2011;15(1): 66-75. doi: https://doi.org/10.3339/jkspn.2011.15.1.66

발열성 소아 요로감염에서 농뇨의 임상적 의의

최림, 조세은, 임형은, 유기환, 홍영숙, 이주원

¹고려대학교 의과대학 소아과학교실
²고려대학교 의과대학 소아과학교실
³고려대학교 의과대학 소아과학교실
⁴고려대학교 의과대학 소아과학교실
⁵고려대학교 의과대학 소아과학교실
⁶고려대학교 의과대학 소아과학교실

Clinical Significance of Pyuria in Pediatric Patients with Febrile Urinary Tract Infection

Lim Choi, Sea-Eun Cho, Hyung-Eun Yim, Kee-Hwan Yoo, Young-Sook Hong, Joo-Won Lee

¹Department of Pediatrics, Guro Hospital, Korea University
²Department of Pediatrics, Guro Hospital, Korea University
³Department of Pediatrics, Guro Hospital, Korea University
⁴Department of Pediatrics, Guro Hospital, Korea University
⁵Department of Pediatrics, Guro Hospital, Korea University
⁶Department of Pediatrics, Guro Hospital, Korea University

Received: March 19, 2011; Accepted: April 25, 2011.

ABSTRACT

Purpose: Early diagnosis and treatment of febrile urinary tract infection (UTI) in children is important to prevent kidney damage. This study aims to evaluate the relationship between the presence of pyuria, the severity, and underlying genitourinary anomalies in patients with UTI.
Methods: We retrospectively reviewed 293 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from June, 2007 until January, 2010. We divided the patients into two groups, one with the finding of pyuria at admission, and the other without, and compared the fever duration, white blood cell counts (WBC) and C-reactive protein (CRP) in peripheral bloods, hydronephrosis, cortical defects, vesicoureteral reflux and admission period.
Results : Among the 293 patients with febrile UTI, 189 patients showed findings of pyuria whereas 104 patients did not. Patients with pyuria showed an increment of WBC ($14,694{pm}485.2$ vs. $11,374{pm}451.2/uL$, P <0.05) and CRP ($46.9{pm}3.9$ vs $17.1{pm}3.6$ mg/L, P <0.05) in peripheral blood sample. The presence of cortical defects (21.7 Vs 5.8%, P <0.05) and vesicoureteral reflux (15.9 Vs 6.7%, P <0.05) was also increased in patients with pyuria compared to patients without pyuria. There were no specific differences in fever duration, admission period, and hydronephrosis. Within the group with pyuria, CRP in peripheral blood sample increased proportionally with the increment of pyuria (P <0.05).
Conclusion : In patients with febrile UTI, the increment of WBC in the urine sample can be a helpful predictor for increased CRP in peripheral blood and acute pyelonephritis.

Key words: Urinary tract infection | Pyuria