Significance of sonographically detected bladder debris in children less than 2 years with febrile urinary tract infection

Abstract

Purpose To investigate the relationship between bladder debris found on renal and bladder ultrasonography (RBUS) and the first febrile urinary tract infection (UTI) episode in children under 2 years old. Methods We retrospectively reviewed the data of children aged <2 years with the first febrile UTI. We recorded bladder debris on RBUS and other findings (blood test, urinalysis, and urine culture). Other RBUS findings (renal pelvis debris, renal parenchymal change, wall thickening, and renal collecting system [RCS] dilatation) were recorded. Patients were divided into the debris (D) and non-D groups. Results Of 128 patients (boys: girls = 81:47, mean age = 5.6 +/- 4.2 months), 24 (18.8%) had bladder debris. The mean C-reactive protein (CRP) levels were higher in the D group (6.1 +/- 4.0 vs 4.3 +/- 3.5, P = .03). Twenty-one patients in the D group (87.5%) had hematuria (odds ratio = 3.706, 95% confidence interval = 1.035-13.267, P = .04). No significant differences were seen in the urine culture results between both groups. Significant associations were seen between bladder debris and other RBUS findings such as debris in renal pelvis, renal parenchymal change, and RCS wall thickening. Conclusion Bladder debris on RBUS is a common finding in children aged <2 years during the first febrile UTI. Bladder debris was related to higher CRP levels, hematuria and sonographic findings, but not to urine culture results.