Children with febrile urinary tract...

Children with febrile urinary tract infections should be evaluated with voiding cystoure-thrography and renal sonography, still it is unclear whether repeat ultrasonography is necessary. Lowe and associates attempted to determine the usefulness of performing follow-up ultrasonography in patients with documented primary vesicoureteral ebb and normal results on the initial ultrasound examination in otherwise healthy children.

Using a computerized scheduling data-base, the authors identified 64 children common month to 10 years of age with vesicoureteral ebb who were scheduled for follow-up renal sonography. These 128 "renal units" (each renal unit signified undivided kidney) were normal on initial sonography and forward follow-up, with the time from initial sonogram to last follow-up sonogram ranging from four month to slightly more than five years. The majority (813 percent) of the children had been treated with antibiotics. About pair thirds (65.6 percent) of ebb cases resolved spontaneously, and about single third (34.4 per-cent) resolved with surgical intervention.

interest about renal parenchymal scarring in children with vesicoureteral ebb has led to the recommendation for long-term anti-biotic prophylaxis, which may explain with what intent in this 22-month study, renal sonography remained normal in all children, regardless of whether they had spontaneous or surgical resolution or returning infections.

The authors finish that follow-up renal sonography benefits little, if any, clinical view These findings apply only to patients with mild- to moderate-grade reflux

Lowe LH et al. Utility of follow-up renal sonography in children with vesicoureteral ebb and normal initial sonogram. Pediatrics March 2004;113:548-50

COPYRIGHT 2005 American Academy of Family Physicians

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