論文

査読有り 国際誌
2020年5月

Clinical Characteristics of Pediatric Pyelonephritis Without Pyuria or Bacteriuria.

The Pediatric infectious disease journal
  • Tadafumi Yokoyama
  • ,
  • Yuta Takemura
  • ,
  • Hitoshi Irabu
  • ,
  • Chihiro Taniguchi
  • ,
  • Asumi Jinkawa
  • ,
  • Mari Yamamiya
  • ,
  • Misato Obata
  • ,
  • Kengo Miyashita
  • ,
  • Mika Inoue
  • ,
  • Shinobu Sakazume
  • ,
  • Kazuhide Ohta

39
5
開始ページ
385
終了ページ
388
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1097/INF.0000000000002609

BACKGROUND: The gold standard for the diagnosis of acute pyelonephritis (APN) in children is the finding of both pyuria (P) and bacteriuria (B); however, some APN patients have neither of these findings [APN(P(-);B(-))]. METHODS: In this study, we investigated APN patients who visited our hospital over 14 years to identify specific clinical characteristics of APN(P(-);B(-)). RESULTS: A total of 171 APN patients were included in the study, and of these 29 were APN(P(-);B(-)). Of the APN(P(-);B(-)) patients, 25.9% had vesicoureteral reflux (VUR), the same percentage as the APN(P(+);B(+)) patients, and 69.0% of APN(P(-);B(-)) patients had already taken antibiotics before diagnosis. APN(P(-);B(-)) patients were older and had a longer duration between onset of fever and diagnosis than the patients with pyuria and/or bacteriuria. In addition, they showed higher C-reactive protein levels. APN(P(-);B(-)) patients had high levels of urinary α-1 microglobulin and urinary β-2 microglobulin. CONCLUSIONS: APN is difficult to diagnose in febrile patients who display neither pyuria nor bacteriuria, but as these patients have the same risk for VUR as APN patients with pyuria and bacteriuria, a detailed history establishing the clinical course as well as urinary chemistry investigations, may assist in diagnosis.

リンク情報
DOI
https://doi.org/10.1097/INF.0000000000002609
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32187138

エクスポート
BibTeX RIS