J Korean Soc Emerg Med.  2019 Feb;30(1):61-68. 10.0000/jksem.2019.30.1.61.

The efficacy of lumbar puncture in febrile early infants with urinary tract infection in pediatric emergency department

• Byun SC
• Lee HJ

• KMID: 2441126
• DOI: http://doi.org/10.0000/jksem.2019.30.1.61

Abstract

OBJECTIVE
This study was conducted to identify the characteristics of early infants with urinary tract infection (UTI) who visited the pediatric emergency department (PED) and to investigate the characteristics of patients with cerebrospinal fluid (CSF) pleocytosis and incidence of bacterial meningitis.
METHODS
We retrospectively reviewed the records of UTI infants aged 31 to 90 days presenting at PED whom had lumbar puncture. From September 1, 2014 to August 31, 2017, a total of 225 infants were enrolled.
RESULTS
Twenty three patients had CSF pleocytosis. Of these, two patients were positive for CSF enteroviral polymerase chain reaction, while none were positive for bacterial culture. We compared the characteristics of infants with CSF pleocystosis. There were not diffences in sex, vaccination before fever, general condition, peak body temperature, peripheral white blood cell, C-reactive protein, and procalcitonin between two groups. However, in patients with prematurity history, incidence of CSF pleocytosis was high. Four infants hot bacteremia, and organism of these patients was all Escherichia coli. All of them had negative CSF culture and normal CSF findings.
CONCLUSION
No febrile early infants with UTI had bacterial meningitis. As a result, we must not do conventional test of CSF in patients with UTI.

Keyword

Meningitis; Bacterial; Spinal puncture; Infant; Urinary tract infections

MeSH Terms

Bacteremia
Body Temperature
C-Reactive Protein
Cerebrospinal Fluid
Emergencies*
Emergency Service, Hospital*
Escherichia coli
Fever
Humans
Incidence
Infant*
Leukocytes
Leukocytosis
Meningitis
Meningitis, Bacterial
Polymerase Chain Reaction
Retrospective Studies
Spinal Puncture*
Urinary Tract Infections*
Urinary Tract*
Vaccination
C-Reactive Protein