Girl (age11)with Ecoli 60000 CFU/ml of urineLower backpain while sittingMild de!
Question:
Girl (age11)with Ecoli 60000 CFU/ml of urineLower backpain while sittingMild defects in kidneypoles.Danger?
DMSA SCAN
Findings:
Both kidneys are normal in size and shape while the left kidney is relatively bulky. Subtle defects are seen in upper lower poles of both kidneys without altering the renal outline. Margins of defects are ill defined. Rest of the renal parenchyma show normal and physiological distribution of tubular uptake of the radio tracer.
Relative function :
LK: 54%
RK: 46%
DRCG
Findings:
There is no evidence of tracer activity in the renal-ureteric areas bilaterally during the entire course of the procedure. The time-activity curve generated from dynamic acquisition in the renal and ureteric areas reveals no evidence of increased activity above baseline. The bladder curve descends normally during the act of micturition.
No significant residual actity seen in the bladder.
Opinion:
DMSA scan shows mild tubular disfunction in the upper and lower poles of both kidneys without any scar formation. Follw up DMSA is advisable.
No VUR is evident on either side on DRC
Answers:
Hi,
As a pediatrician I believe that this indicates that she has possibly recurrent UTI that have caused some kidney damage. However the lack of VUR and scarring is a good sign, which means that the damage is not significant at present...and is potentially reversible.
The present episode of UTI needs to be treated aggressively and further prophylaxis with antibiotics maybe planned.
She also needs regular f/u with BP monitoring and urine c/s s per protocol of the local hospital,
regards
Dr. Gupta