Periumbilical swelling, erythema, and discharge in a girl: Questions

Excerpt

A 5-year-old female patient presented with complaints of high fever and urinary turbidity existing for 4 days. Her medical history revealed she was born by cesarean section at 37th gestational week, weighing 2950 g and was operated on for myelomeningocele on the 3rd postnatal day. External ventricular drainage was performed due to hydrocephalus and she was followed up with the diagnoses of spina bifida and neurogenic bladder. The case, who had clean intermittent catheterization (CIC) since infancy, had recurrent febrile urinary tract infections (UTI). Previous voiding cystourethrography (VCUG) of the patient was normal and she had grade 4 hydronephrosis in bilateral kidneys, dilatation in bilateral ureters, thinning in bilateral renal parenchyma thickness, increased bladder wall thickness, and trabeculation in ultrasonographic examination 6 months before admission. Urodynamic examination revealed her bladder volume was low and intravesical pressure was high. …