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Pediatric Nephrology

, Volume 16, Issue 6, pp 503–506 | Cite as

Role of Tc-99m DMSA scintigraphy in the diagnosis of culture negative pyelonephritis

  • Elena N. Levtchenko
  • Cécile Lahy
  • Jack Lévy
  • H. R. Ham
  • Amy Piepsz
Brief Report

Abstract 

The aim of this work was to evaluate prospectively the proportion of children with a clinical and biological presentation of acute pyelonephritis, abnormal Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy and negative or equivocal urine cultures. All patients aged 6 weeks to 15 years suspected of acute pyelonephritis (APN) were admitted to the Paediatric Department and underwent Tc-99m DMSA scintigraphy within 3 days after admission and at 6 months. Of 166 patients enrolled in the study, 15 (9%) had negative or equivocal urine culture despite clinical and scintigraphic evidence of APN. Of these 15 children, renal ultrasound was normal in 7 patients and vesicoureteric reflux was found in 9 patients. Control DMSA 6 months after acute episode showed the disappearance of cortical lesions in eight and partial improvement in four patients. In this prospective series, as many as 9% of patients with APN would have been missed on the basis of equivocal or negative urine cultures. It is suggested that Tc-99m DMSA scintigraphy should be performed in children with severe infection without clear aetiology, especially in those with abnormal urinalysis.

Keywords Urinary tract infection Acute pyelonephritis Children Negative urine culture Technetium-99m dimercaptosuccinic acid Tc-99m DMSA 

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Copyright information

© IPNA - International Pediatric Nephrology Association New York, USA 2001

Authors and Affiliations

  • Elena N. Levtchenko
    • 1
  • Cécile Lahy
    • 2
  • Jack Lévy
    • 2
  • H. R. Ham
    • 3
  • Amy Piepsz
    • 3
  1. 1.Department of Paediatrics, Academic Hospital, Free University, Brussels, BelgiumBE
  2. 2.Department of Paediatrics, CHU St. Pierre, Brussels, BelgiumBE
  3. 3.Department of Nuclear Medicine, CHU St. Pierre, Brussels, BelgiumBE

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