RESUMO
Elevated surum levels of C-reactive protein have been found regularly in girls with acute clinical pyelonephritis but only infrequently in those with clinical cystitis. Based on these data, the suggestion has been made that elevated serum CRP concentrations may be useful in identifying patients with upper urinary tract infections. In a study in which the bladder washout test was used to localize the site of urinary tract infections, we identified nine girls with renal bacteriuria who did not have clinical findings suggesting acute pyelonephritis; four of these girls had serum CRP concentrations less than 10 micrograms/ml. Twenty-eight girls had bladder washout-proven lower urinary tract infections; three of these had serum CRP values greater than 30 micrograms/ml. These studies show that an elevated serum CRP concentration is not accurate in localizing the site of a urinary tract infection in girls who do not have clinical signs of acute pyelonephritis.
Assuntos
Proteína C-Reativa/análise , Infecções Urinárias/diagnóstico , Adolescente , Bacteriúria/diagnóstico , Criança , Pré-Escolar , Cistite/diagnóstico , Feminino , Humanos , Pielonefrite/diagnósticoRESUMO
The data from 100 bladder washout studies on pediatric patients have been analyzed to derive criteria for interpretation of this test and to define the limitations of this procedure in localization of the site of urinary tract infections. Using the bladder washout test, infection of the upper urinary tract is characterized by an abrupt increase in the concentration of bacteria in urinary specimens collected following urinary bladder sterilization. Infection limited to the lower urinary tract is characterized by scant if any bacterial growth in the specimens of urine collected following bladder sterilization. The site of infection may be incorrectly localized to the lower urinary tract or classified as not determined in patients with scant or intermittent renal bacteriuria.