J Korean Soc Pediatr Nephrol.  2008 Apr;12(1):70-77.

Fever Duration and Renal Scar in Pediatric Urinary Tract Infection

• Jung JI
• Lim DH
• Yim HE
• Park MS
• Yoo KH
• Hong YS
• Lee JW

Abstract

PURPOSE
Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars.
METHODS
The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature > or =37.5degrees C, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR).
RESULTS
1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2)Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05).
CONCLUSIONS
Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.

Keyword

Urinary tract infection; Fever; Scar; C-reactive protein; Leukocytes; Vesico-ureteral reflux

MeSH Terms

Anti-Bacterial Agents
C-Reactive Protein
Cicatrix
Fever
Humans
Leukocytes
Leukocytosis
Medical Records
Retrospective Studies
Urinary Tract
Urinary Tract Infections
Vesico-Ureteral Reflux
Anti-Bacterial Agents
C-Reactive Protein