Clinically Unsuspected Pyelonephritis in Young Children

Background: Acute pyelonephritis is the most common serious bacterial infection in children and is a common cause for emergency department presentation. Most children with urinary tract infection (UTI) and fever have pyelonephritis. The diagnosis is typically based on clinical evaluation, urinalysis, and urine cultures, but this can be challenging in young children as they often present with nonspecific symptoms. CT may be helpful in equivocal cases. CT findings of pyelonephritis include striated enhancement, hypodensity, perirenal stranding, and uroepithelial enhancement. Objective: To evaluate the incidence and characteristics of CT-diagnosed clinically unsuspected pyelonephritis in children aged Design: Retrospective study. Methods: Data from 104 children aged Results: 88.5% of patients had no history of UTI; 32.7% were symptomatic. Pyelonephritis was clinically unsuspected in 51.0%, with no significant age group difference. Urinalysis was negative in 16.3% of patients, and 26 chi more...