uti x renal US xmcug

Voiding cystourethrogram (VCUG) in neonates with first-time febrile UTI (September 2017)

For neonates with first-time urinary tract infection (UTI), the optimal approach to evaluating for vesicoureteral reflux (VUR) is uncertain, and expert opinion differs as to whether a voiding cystourethrogram (VCUG) is necessary in all cases. A recent study of 122 young infants with first-time febrile UTI found that high-grade VUR was far less likely among infants with normal renal ultrasound and Escherichia coli infection compared with those with abnormal renal ultrasound, non-E. coli pathogen, or both abnormal ultrasound and non-E. coli pathogen (1 versus 31, 26, and 55 percent, respectively) [18]. These data suggest that a VCUG may not be necessary for all neonates with first-time UTI, and they support a strategy of "watchful waiting" for low-risk infants. However, VCUG should be performed in neonates with abnormal renal ultrasound, non-E. coli pathogen, or recurrent UTI