Febrile Urinary Tract Infections in Children
نویسنده :
تاریخ انتشار : 1397/03/12
Antibiotic treatment of children with febrile urinary tract infections has almost
eliminated the risk of death, which was approximately 20% among children hospitalized
for acute pyelonephritis in the early 20th century. Some 50 years ago, one
study described renal parenchymal injury in 210 of 597 children treated for recurrent
urinary tract infections. Another study in that era reported on an 11-to-27-year
follow-up of 72 children hospitalized for urinary tract infections; 18% had died, 8%
had progressive renal insufficiency, and 22% had persistent untreated or recurrent
infection. Both studies assumed that kidney damage was related solely to urinary
tract infection, overlooking the possibility that congenital renal abnormalities contributed
to these outcomes. In the early 1970s, the evolving concept of reflux nephropathy
linked vesicoureteral reflux to pyelonephritis and late renal scarring.
Consequently, children who had had febrile urinary tract infections were routinely
evaluated for urinary tract abnormalities and often received long-term antibiotic prophylaxis10,;
surgical correction of vesicoureteral reflux became standard care.