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Original Article
Infection
Febrile urinary tract infection in children: changes in epidemiology, etiology, and antibiotic resistance patterns over a decade
Woosuck Suh, Bi Na Kim, Hyun Mi Kang, Eun Ae Yang, Jung-Woo Rhim, Kyung-Yil Lee
Clin Exp Pediatr. 2021;64(6):293-300.   Published online October 14, 2020
Question: How has the antibiotic susceptibility of urinary pathogens changed and what does it imply?
Finding: A yearly increase in multidrug-resistant and extended-spectrum β-lactamase (ESBL)–producing pathogens was observed. A higher recurrence rate was observed in cases of febrile urinary tract infection caused by ESBL producers in patients with underlying vesicoureteral reflux (VUR).
Meaning: The initial empirical antibiotic should reflect the changing susceptibility patterns and underlying VUR status.
Serum levels of interleukin-6 and interleukin-8 as diagnostic markers of acute pyelonephritis in children
Abolfazl Mahyar, Parviz Ayazi, Mohammad Reza Maleki, Mohammad Mahdi Daneshi-Kohan, Hamid Reza Sarokhani, Hassan Jahani Hashemi, Mousa Talebi-Bakhshayesh
Clin Exp Pediatr. 2013;56(5):218-223.   Published online May 28, 2013
Purpose

Early diagnosis and treatment of acute pyelonephritis in children is of special importance in order to prevent serious complications. This study was conducted to determine the diagnostic value of serum interleukin (IL)-6 and IL-8 in children with acute pyelonephritis.

Methods

Eighty-seven patients between 1 month to 12 years old with urinary tract infection (UTI) were divided into 2 groups based on the...

Discordant findings on dimercaptosuccinic acid scintigraphy in children with multi-detector row computed tomography-proven acute pyelonephritis
Jeongmin Lee, Duck Geun Kwon, Se Jin Park, Ki-Soo Pai
Clin Exp Pediatr. 2011;54(5):212-218.   Published online May 31, 2011
Purpose

The diagnosis of acute pyelonephritis (APN) is often difficult, as its clinical and biological manifestations are non-specific in children. If not treated quickly and adequately, however, APN may cause irreversible renal damage, possibly leading to hypertension and chronic renal failure. We were suspecting the diagnostic value of 99mTc-dimercaptosuccinic acid (DMSA) scan by experiences and so compared the results of DMSA...

Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children
Byung Gee Kim, Jae Ryoung Kwak, Ji Min Park, Ki Soo Pai
Clin Exp Pediatr. 2010;53(3):408-413.   Published online March 15, 2010
Purpose : We aimed to prove the relative limitation of 99mTc-DMSA scintigraphy (DMSA) compared to computed tomography (CT) in diagnosing acute pyelonephritis (APN) in children. Methods : Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as...
Usefulness of serum procalcitonin test for the diagnosis of upper urinary tract infection in children
Dong Wook Kim, Ju Young Chung, Ja Wook Koo, Sang Woo Kim, Tae Hee Han
Clin Exp Pediatr. 2006;49(1):87-92.   Published online January 15, 2006
Purpose : It is difficult to make a distinction between lower urinary tract infection(UTI) and acute pyelonephritis(APN) during the acute phase of febrile UTI due to nonspecific clinical symptoms and laboratory findings, especially among young children. We measured the serum procalcitonin(PCT) in children with UTI to distinguish between acute pyelonephritis and lower UTI, and to determine the accuracy of PCT...
Risk Factors of Renal Scar After Acute Pyelonephritis in Children
Chur Woo You
Clin Exp Pediatr. 2001;44(1):54-61.   Published online January 15, 2001
Purpose : In this study we re-evaluated the known risk factors of pyelonephritic scarring in children. Methods : A prospective study was performed on 36 acute pyelonephritis(APN) patients who were diagnosed as first acute pyelonephritis on 99mTc-DMSA scan between September 1998 and March 2000 in Masan Samsung Hospital. According to the prescence of remnant lesions on the 99mTc-DMSA scan performed...
Changes in the Findings of 99mTc-dimercaptosuccinic Acid(DMSA) Scan after Acute Pyelonephritis in Childhood and Renal Scar
Sang Hee Ahn, So Young Yoon, Chong Hyun Yoon, Dae Hyuk Moon, Young Seo Park
Clin Exp Pediatr. 2000;43(4):543-549.   Published online April 15, 2000
Purpose : We evaluated the change in the findings of DMSA scan after acute pyelonephritis (APN), and the relationship between renal scar formation and risk factors such as vesicoureteral reflux(VUR), organism and inflammatory reaction. Methods : We examined 200 patients under the age of 5 years with first APN. DMSA scan, voiding cystourethrography(VCUG), erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP) were...
The Risk Factors of Renal Scar in Childhood Acute Pyelonephritis
Soo Ja Hwang, Seung Joo Lee
Clin Exp Pediatr. 1999;42(4):545-552.   Published online April 15, 1999
Purpose : To observe the risk factors of renal scar in children with first acute pyelonephritis (APN) who had photopenic defects on initial 99mTc-DMSA spect renal scan. Methods : Forty-seven children with first APN(M : F=33 : 14) who were admitted to Ewha Womans University Hospital from September, 1993 to Febrary, 1998, were divided into renal scar group(N=17, Kidney unit(KU)=18) and...
Diagnostic Value of 99mTc-DMSA Renal Scan for Early Diagnosis of Acute Pyelonephritis in Children with Febrile Urinary Tract Infection
Soo Ja Hwang, Eun Ae Park, Jeong Wan Seo, Seung Joo Lee, Sun Whan Lee
Clin Exp Pediatr. 1996;39(11):1586-1593.   Published online November 15, 1996
Purpose : For prevention of renal scar, early diagnosis and treatement of acute pyelonephritis are important in children with febrile urinary tract infection. But it has been difficult to differentiate acute pyelonephritis from lower urinary tract infection. We have performed this study to evaluate the diagnostic value of 99mTc-DMSA renal scan and to clarify the relationship among acute pyelonephritis, vesico-ureteral reflux and renal scar. Methods...
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