CT Abdomen and Pelvis Without and With IV Contrast There is no relevant literature to support the use of CT abdomen and pelvis without and with IV contrast in the evaluation of a child AFAB <2 months of age for the initial imaging of a first febrile UTI. CT Abdomen and Pelvis Without IV Contrast There is no relevant literature to support the use of CT abdomen and pelvis without IV contrast in the evaluation of a child AFAB <2 months of age for the initial imaging of a first febrile UTI. CTU Without and With IV Contrast There is no relevant literature to support the use of CTU in the evaluation of a child AFAB <2 months of age for the initial imaging of a first febrile UTI. DMSA Renal Scan A Tc-99m DMSA scan can be done for initial imaging, close to the time of febrile UTI, to evaluate for the presence of pyelonephritis. This top-down approach has been suggested in literature. If the DMSA scan is normal, VCUG may be avoided in more than 50% of individuals [14]. Tc-99m DMSA has a good image quality and is a desirable agent for renal cortical scintigraphy, especially in small infants, in patients with poorly functioning kidneys, and when other studies have identified dilated uropathy or high-grade VUR [15]. The NICE guidelines do not recommend DMSA for infants <6 months of age with first febrile UTI who respond well to treatment within 48 hours, but they do recommend DMSA for atypical or recurrent UTI [16]. Fluoroscopy Voiding Cystourethrography A finding of VUR, especially high-grade VUR, may lead to a change in management [9]. The NICE guidelines do not recommend VCUG for infants AFAB <6 months of age with first febrile UTI who respond well to treatment within 48 hours. Furthermore, recent data has shown that in children <3 months of age with first febrile UTI, the presence of E coli in urine, and normal renal and bladder US, VCUG can be safely avoided [18].
Urinary Tract Infection Child. CT Abdomen and Pelvis Without and With IV Contrast There is no relevant literature to support the use of CT abdomen and pelvis without and with IV contrast in the evaluation of a child AFAB <2 months of age for the initial imaging of a first febrile UTI. CT Abdomen and Pelvis Without IV Contrast There is no relevant literature to support the use of CT abdomen and pelvis without IV contrast in the evaluation of a child AFAB <2 months of age for the initial imaging of a first febrile UTI. CTU Without and With IV Contrast There is no relevant literature to support the use of CTU in the evaluation of a child AFAB <2 months of age for the initial imaging of a first febrile UTI. DMSA Renal Scan A Tc-99m DMSA scan can be done for initial imaging, close to the time of febrile UTI, to evaluate for the presence of pyelonephritis. This top-down approach has been suggested in literature. If the DMSA scan is normal, VCUG may be avoided in more than 50% of individuals [14]. Tc-99m DMSA has a good image quality and is a desirable agent for renal cortical scintigraphy, especially in small infants, in patients with poorly functioning kidneys, and when other studies have identified dilated uropathy or high-grade VUR [15]. The NICE guidelines do not recommend DMSA for infants <6 months of age with first febrile UTI who respond well to treatment within 48 hours, but they do recommend DMSA for atypical or recurrent UTI [16]. Fluoroscopy Voiding Cystourethrography A finding of VUR, especially high-grade VUR, may lead to a change in management [9]. The NICE guidelines do not recommend VCUG for infants AFAB <6 months of age with first febrile UTI who respond well to treatment within 48 hours. Furthermore, recent data has shown that in children <3 months of age with first febrile UTI, the presence of E coli in urine, and normal renal and bladder US, VCUG can be safely avoided [18].