Radiological profile of children under 2 years of age from South India with urinary tract infection

Objective: To assess the proportion of children less than 2 years of age with urinary tract infection (UTI) having structural anomalies detected by screening ultrasonography (USG) and voiding cystourethrography (VCUG). Method: A prospective observational study was done in a tertiary care hospital in South India from May 2014 to April 2015 on children less than 2 years of age, attending the paediatric or paediatric urology outpatient department and paediatric and neonatal wards, with symptoms suggestive of UTI. All urine culture positive cases were included in the study except for cases who had undergone operative procedures and catheterisation of urinary tract. Screening USG and VCUG were performed. Results: The radiological profile of UTI was analysed in the study group comprising 216 children less than 2 years of age. Radiological abnormalities were detected in 82 (38%) cases with female predominance. Fifty three (64.6%) of the abnormalities were identified by USG and 41 (50%) by VCUG. On USG, cystitis and pyelonephritis were the common abnormalities seen whilst vesicoureteral reflux (VUR) and posterior urethral valves (PUV) were the common abnormalities seen on VCUG. The 34 children with VUR had grades I and II reflux in 73.4%, grade III and IV reflux in 23.4% and grade V reflux in 3.2% cases. Four (11.7%) children had bilateral reflux. Conclusions: Radiological abnormalities were detected in 38% children less than 2 years of age with UTI by screening USG and VCUG.