Children with abnormal DMSA nuclear scan present a higher risk of recurrent febrile urinary tract infections

Excerpt

The ideal management of a child presenting a first episode of febrile urinary tract infection is still under debate. In the recent guidelines for the diagnosis and management of urinary tract infections (UTI) in children, the American Association of Pediatrics recommend performing a post-UTI sonography, and if there are abnormal findings, a voiding cystourethrogram [1]. This change derives from the understanding that we should be avoiding renal damage rather more than diagnosing reflux, since both surgery and antibiotic prophylaxis are progressively being abandoned for most cases of vesicoureteral reflux (VUR) [2, 3]. The most significant event which will bring a child to active management is recurrence of UTI [4, 5]. It seems therefore more clinically relevant to differentiate between children who will suffer recurrent episodes of UTI and those who will not, rather than to simply identify which children have VUR. We therefore aimed to evaluate if DMSA nuclear scan could reliably identify which children were at risk of presenting a second febrile UTI. …