Urinary Tract Infection in Outpatient Febrile Infants Younger Than 30 Days of Age

A 10-Year Evaluation

William Bonadio, MD; Gary Maida, MD

Pediatr Infect Dis J. 2014;33(4):342-344.

Conclusions

UTI is present in 1 of 6 febrile neonates presenting for outpatient evaluation. Nearly 50% have a radiographic anatomic abnormality and one-fourth with hydronephrosis have VUR. All febrile young infants should receive performance of a urine culture; those with UTI require RUS imaging. Those with hydronephrosis should have further evaluation for VUR. The purpose of renal imaging is to detect urologic abnormalities that require additional management, such as further radiographic studies or subspecialty consultation. Identifying abnormalities is important to determine prognosis and establish appropriate follow up and monitoring so as to maximize renal function.

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Table 1. Characteristics of 100 Febrile Infants ≤30 Days of Age With UTI.
Male gender	73 (73%)
Mean patient age	23.3 days
Mean patient age with hydronephrosis on RUS	25.2 days
Mean patient age with normal RUS	22.6 days
Mean maximum measured rectal temperature	101.9°F
Maximum measured rectal temperature	≥102°F 39 (39%)
Mean CBC total WBC count	14,400/mm³
CBC total WBC count ≥15,000/mm³	40 (40%)
Positive urine dipstick test for leukocyte esterase or nitrite	69/87 (79%)
Negative urine dipstick test for leukocyte esterase or nitrite	18/87 (21%)
Urosepsis (bacteremia with UTI)	4 (4%)
Bacterial meningitis	0
Deaths	0