尿道分泌物作为24个月及以下儿童尿路感染的早期表现。
Urethral discharge as an early manifestation of urinary tract infection in children ≤24 months old.
作者信息
Fang Nai-Wen, Ou Shih-Hsiang, Huang Yu-Shan, Chiou Yee-Hsuan
机构信息
Department of Pediatrics, Pingtung Veterans General Hospital, Pingtung, Taiwan.
Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
出版信息
Front Pediatr. 2023 Jun 19;11:1149218. doi: 10.3389/fped.2023.1149218. eCollection 2023.
BACKGROUND
Children with febrile urinary tract infections (UTIs) are prone to kidney scarring if they are not treated promptly; however, ambiguous symptoms before fever onset makes the early detection of UTIs difficult. Our study aimed to identify urethral discharge as an early manifestation in children with UTI.
METHODS
This study enrolled 678 children younger than 24 months with paired urinalysis and culture performed between 2015 and 2021; 544 children were diagnosed with UTIs. Clinical symptoms, urinalysis, and paired urine culture results were compared.
RESULTS
Urethral discharge was observed in 5.1% of children with UTI and yielded a specificity of 92.5% for diagnosing UTI. Children with urethral discharge had a less severe UTI course, furthermore, nine of them received antibiotics before fever occurred and seven of them were free of fever during UTI course. Urethral discharge was associated with alkalotic urine and infection.
CONCLUSIONS
Urethral discharge is an early symptom in children with UTI; it may present before fever onset and help ensure prompt antibiotic intervention.
背景
发热性尿路感染（UTI）患儿若未得到及时治疗，容易出现肾瘢痕；然而，发热发作前症状不明确使得UTI的早期检测较为困难。我们的研究旨在确定尿道分泌物为UTI患儿的早期表现。
方法
本研究纳入了678名24个月以下的儿童，他们在2015年至2021年间进行了配对尿液分析和培养；544名儿童被诊断为UTI。比较了临床症状、尿液分析和配对尿液培养结果。
结果
5.1%的UTI患儿出现尿道分泌物，其诊断UTI的特异性为92.5%。有尿道分泌物的患儿UTI病程较轻，此外，其中9名患儿在发热前接受了抗生素治疗，7名患儿在UTI病程中未发热。尿道分泌物与碱性尿液和感染有关。
结论
尿道分泌物是UTI患儿的早期症状；它可能在发热发作前出现，并有助于确保及时进行抗生素干预。
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