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J Korean Soc Emerg Med > Volume 30(1); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(1): 61-68.
발열을 주소로 응급실로 내원하여 요로감염으로 진단된 어린 영아에서 요추천자 검사의 효용성
변성철 , 이현정
순천향대학교 천안병원 응급의학과
The efficacy of lumbar puncture in febrile early infants with urinary tract infection in pediatric emergency department
Sung Chul Byun , Hyun Jung Lee
Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
Correspondence  Hyun Jung Lee ,Tel: 041-570-3859, Fax: 041-570-3924, Email: silenos@schmc.ac.kr,
Received: July 6, 2018; Revised: October 3, 2018   Accepted: October 4, 2018.  Published online: February 28, 2019.
This study was conducted to identify the characteristics of early infants with urinary tract infection (UTI) who visited the pediatric emergency department (PED) and to investigate the characteristics of patients with cerebrospinal fluid (CSF) pleocytosis and incidence of bacterial meningitis.
We retrospectively reviewed the records of UTI infants aged 31 to 90 days presenting at PED whom had lumbar puncture. From September 1, 2014 to August 31, 2017, a total of 225 infants were enrolled.
Twenty three patients had CSF pleocytosis. Of these, two patients were positive for CSF enteroviral polymerase chain reaction, while none were positive for bacterial culture. We compared the characteristics of infants with CSF pleocystosis. There were not diffences in sex, vaccination before fever, general condition, peak body temperature, peripheral white blood cell, C-reactive protein, and procalcitonin between two groups. However, in patients with prematurity history, incidence of CSF pleocytosis was high. Four infants hot bacteremia, and organism of these patients was all Escherichia coli. All of them had negative CSF culture and normal CSF findings.
No febrile early infants with UTI had bacterial meningitis. As a result, we must not do conventional test of CSF in patients with UTI.
Key words: Meningitis; Bacterial; Spinal puncture; Infant; Urinary tract infections
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