The Value of C-reactive Protein, Procalcitonin, Interleukin-6 Levels to Predict Urinary Tract Infection in Children with Fever without A Focus

Objective: Urinary tract infections (UTIs) are one of the most common causes of acute fever without a focus in children between 1-36 months old, although obtaining urine for urine analysis is technically difficult in this age group. Therefore, there is a need for clinical and laboratory evidence to predict UTIs. The aim of this study is to determine the frequency of urinary tract infections in children between 1-36 months with acute fever of without a focus and the laboratory evidence, like C-reactive protein, procalcitonin, and interleukin-6 levels, that would help to predict urinary tract infections. Material and Methods: Febrile children presenting to a pediatric emergency department, ages ranging between 1-36 months old and body temperature being ≥38.0°C, with a source of fever that was undetectable clinically, were enrolled in this prospective study. Patients were evaluated according to clinical and laboratory findings. The data were analyzed using SPSS software, version 15.0. Results: A total of 90 patients were enrolled in this study. The median age was 7 months. The frequency of urinary tract infections was 25%. Escherichia coli was detected in all cases with positive urine cultures. There was no difference in clinical features between children with and without urinary tract infections. Laboratory findings, including white blood cell count, absolute neutrophil count, peripheral blood smear, and interleukin-6, were not statistically different between the two groups, whereas C-reactive protein and procalcitonin levels were significantly higher in the UTI group (p<0.05). Conclusion: In conclusion, UTI is a frequent infection in 1-36-month-old children with fever without a focus, and the urine test with urine culture must certainly be assessed in these children. Laboratory findings, including C-reactive protein and procalcitonin, can be used as supporting evidence. There is a need for large trials evaluating the value of interleukin-6 levels to predict urinary tract infections in children.(J Pediatr Inf 2014; 8: 165-70)