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Updated on January 8, 2025

UTI in a Paediatric Patient

Clinical History

A 14-year old boy presented with long-standing recurrent UTI symptoms with some fever.

Case Description

Ultrasound revealed a thick and irregular urinary bladder wall outline. There was some debris seen within the bladder lumen. The pre void bladder volume was 182 ml, while the post void bladder volume was 105 ml (incomplete bladder emptying). In addition, there was also an area of focal thickening seen in the left ureteric orifice measuring 16 mm x 11 mm (L x AP). Although the ureters were not obstructed as there was no hydroureter, and the bladder jets were within optimal limits. There was no hydronephrosis either, however, the left urothelium was mildly thickened as seen in the left renal pelvis indicating a UTI.

Diagnosis/ Discussion/ Treatment/ Follow up

The patient was placed on antibiotics therapy which helped resolve the symptoms.

Sonograms

A distended urinary bladder showing an increased wall thickness. Note the numerous debris within the bladder lumen indicating a UTI
A distended urinary bladder showing an increased wall thickness. Note the numerous debris within the bladder lumen
A dual-screen image of the bladder volume measurement
A dual-screen image of the bladder volume measurement
Thickening of the left ureteric orifice (transverse orientation) appearing as an echogenic protrusion into the bladder lumen
Thickening of the left ureteric orifice (transverse orientation) appearing as an echogenic protrusion into the bladder lumen
Thickening of the left ureteric orifice (longitudinal orientation) appearing as an echogenic protrusion into the bladder lumen
Thickening of the left ureteric orifice (longitudinal orientation) appearing as an echogenic protrusion into the bladder lumen
Bladder jet from the left ureteric orifice indicating a lack of obstruction in the bladder inlet
Bladder jet from the left ureteric orifice indicating a lack of obstruction in the bladder inlet
A dual-screen image of the bladder showing b-mode and colour Doppler simultaneously. Good bladder jets were recorded from both right and left ureteric orifices
A dual-screen image of the bladder showing b-mode and colour Doppler simultaneously. Good bladder jets were recorded from both right and left ureteric orifices
Left kidney transverse view showing thickness of the urothelium
Left kidney transverse view showing thickness of the urothelium
Axial left kidney showing urothelial thickening
Axial left kidney showing urothelial thickening
Post void with a significant amount of post void residual bladder volume of 105 ml
Post void with a significant amount of post void residual bladder volume of 105 ml

Published on: September 18, 2024

Author

Sonohive

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