Association of first urinary tract infection in children with urinary tract abnormalities

Background: urinary tract infections (uti) may be a variety of presentation of under lying urinary tract abnormalities including obstructive uropathy,vesicoureteral reflex (vur),renal calculi and urethral duplication. the long term complications of (uti) with these conditions are hypertension,renal scaring and chronic renal failure (crf). aim: to determine the incidence of first uti associated with urinary tract abnormalities. methods: this study was carried out in the department of nephrology,sandeman provincial hospital/bolan medical college,quetta. we reviewed 78 patients who were hospitalized with symptomatic uti during a 3 year period (january 2009 to december 2012). the age limits were two months to 15 years. patients with incomplete investigations were excluded from the study. seventy patients were included in the study (50 girls and 20 boys). confirmed cases of uti underwent renal and urinary tract ultrasongraphy (us),micturating cystourethrougrephy (mcug) and 99m tc- dimercaptosuccinic acid (dmsa) scan. results: the common causative agent was e-coil (75.5%). the most common presentation was fever in 62 cases and dysuria in 42.8% vur was found in 24 patients (34.2%),70.8% girls and 29.2% boys. other urinary tract abnormalities were kidney stone in 7%,obstructive hydronephrosis in 4.2%,neurogenic bladders in 4.2%,double collecting system in one patient and posterior urethral valves in two boys respectively. conclusion: 35% of pts had vur & 20% had other associated abnormalities in urinary tract we recommend that us,mcmg and dmsa scan should be routinely performed on all pts after first uti.