Risk factors in the development of early technetium-99m dimercaptosuccinic acid renal scintigraphy lesions during first urinary tract infection in children

Acta Paediatr. 2003;92(1):21-6. doi: 10.1111/j.1651-2227.2003.tb00463.x.

Abstract

Aim: To establish the variables that correlate with uptake defects in dimercaptosuccinic acid (DMSA) scintigraphy performed in the acute phase of a first episode of urinary tract infection (UTI).

Methods: A prospective observational study was conducted in a cohort of 158 consecutive children with a first episode of symptomatic UTI. The therapeutic delay time (TDT) was recorded. DMSA scintigraphy was performed in all children and voiding cystourethrography in 150 of them.

Results: 85% of the patients were younger than 2 y. Mean TDT was 33.5 h. The aetiological agent was Escherichia coli in 140 children. DMSA scintigraphy was normal in 81. Vesicoureteric reflux was detected in 33. After a multivariate logistic regression analysis the following variables were retained in the final model: TDT > or = 48 h, growth of bacteria other than E. coli, percentage of polymorphonuclear cells > or = 60% and C-reactive protein > or = 30 mg l(-1).

Conclusion: TDT > or = 48 h, bacteria other than E. coli, percentage of polymorphonuclear cells > or = 60% and CRP > or = 30 mg l(-1) influence the findings detected in the DMSA scintigraphy performed in the acute phase of a first episode of UTI.

MeSH terms

  • Acute Disease
  • Cohort Studies
  • Escherichia coli Infections / complications
  • Female
  • Humans
  • Infant
  • Male
  • Predictive Value of Tests
  • Prospective Studies
  • Radiopharmaceuticals / adverse effects*
  • Risk Factors
  • Technetium Tc 99m Dimercaptosuccinic Acid / adverse effects*
  • Time Factors
  • Tomography, Emission-Computed
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / microbiology
  • Vesico-Ureteral Reflux / chemically induced*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid