Level Diagnosis of Symptomatic Urinary Tract Infections in Childhood

ABSTRACT: Jodal, U., Lindberg, U. and Lincoln, K. (Department of Paediatrics and Institute of Medical Microbiology, University of Göteborg, Göteborg, Sweden). Level diagnosis of symptomatic urinary tract infections in childhood. Acta Paediatr Scand, 64:201, 1975.–As no method for localization of urinary tract infection has been shown to be absolutely reliable, six procedures have been carried out simultaneously in 25 girls with acute symptomatic infections and the reliability of each method assessed. While clinical diagnosis of pyelonephritis or cystitis correlated well with the overall results of the battery of tests, the reliability of individual tests varied. Highest reliability was obtained with CRP determinations followed by antibody titration, sedimentation rate, and renal concentrating capacity. In the bladder washout test only 8 of the 14 patients with pyelonephritis had findings clearly indicating high infection. Intermittent or inadequate discharge of bacteria from the renal parenchyma is suggested as the major source for this inaccuracy. In fact, half of the 42 final washout specimens from girls with acute pyelonephritis contained less than 1 000 bacteria per ml, indicating that low numbers of organisms in ureteric urine is common in childhood pyelonephritis.