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Advances in Urology
Volume 2011, Article ID 397618, 7 pages
http://dx.doi.org/10.1155/2011/397618
Research Article

Procalcitonin: A Key Marker in Children with Urinary Tract Infection

1Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Linton Road, Oxford OX2 6UD, UK
2Pasteur Institute, 75015 Paris, France
3Department of Pediatrics, University Hospital of Geneva, 1211 Geneva, Switzerland

Received 1 November 2010; Revised 20 December 2010; Accepted 21 December 2010

Academic Editor: Ming Hsien Wang

Copyright © 2011 Sandrine Leroy and Alain Gervaix. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Urinary tract infections (UTIs) are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesicoureteral reflux (VUR) is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar) or cystography (for VUR) and present limitations (feasibility, pain, cost, etc.). Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of both renal parenchymal involvement in the acute phase and late renal scars. Furthermore, it was also found to be associated with high-grade VUR and was the key tool of a clinical decision rule to predict high-grade VUR in children with a first UTI. Therefore, procalcitonin may certainly be found playing a role in the complex and still debated picture of which examination should be performed after UTI in children.