CLINICAL INDICATION FOR ECHOGRAPHY IN ACUTE PYELONEPHRITIS IN ADULT WOMEN

Background. Echography is a non-invasive procedure which detects abnor malities in kidney and/or urinary tract. Objective. To determine wheth er the routine use of an echography in women with the diagnosis of acu te pyelonephritis (APN) provides relevant findings to diagnosis and de termines a change in therapy. Material and methods. A total of 100 pat ients admitted to the hospital with the diagnosis of APN who had under gone an echography were studied. Seven clinical criteria were evaluate d: persistent fever for longer than 72 hours after starting an appropr iate antibiotic therapy, episodes of previous urinary tract infections , previous history of kidney stones, anatomic abnormalities in the uri nary tract, colic pain, persistent hematuria, and pregnancy. On the ba sis of these criteria two groups were defined: a) indicated echography (IE), for patients fulfilling at least one the above criteria; b) non -indicated echography (NIE), for patients fulfilling none of the above criteria. Results. IE group was made up of 47 patients, with a normal echography in 18 (38%); the NIE group was made up of 53 women, with a normal echography in 51 of them (96%). The abnormal findings in echog raphy led to a change in therapeutic behaviour in 11 patients in the I E group (23%) and in 2 patients in the NIE group (4%). Conclusions. Th e routine use of abdominal echography in women with the diagnosis of A PN is not indicated in absence of clinical data supporting the presenc e of a complicated APN.