[Interdisciplinary day-care hospitalization among cooperating pediatric services. The experience of Hôpital Trousseau (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Bensman.
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In order to study the value of the tetrazolium nitroblue test (TNB) in the localisation of urinary tract infections, the authors performed this test in 33 patients with a urinary tract infection and in 20 control children suffering from no bacterial infection. The 33 infected children were divided into three groups on the basis of clinical and bacteriological criteria (dysuria, frequency, fever, abdominal pain, inflammatory syndrome, immunofluorescence of bacteriuria, serum antibody levels): -- group A (8 children): upper urinary infection -- group B (14 children): lower urinary infection -- group C (11 children): urinary infection of undetermined site. The number and percentage of TNB positive polynuclears was significantly higher in the children of group A than in the children of group B (p 0.001). By contrast there was no significant difference between the results obtained: in the non-infected control group and in group B -- in group A and group C. These results, confirming a previous study by Bjorksten and de Chateau, show the value of the TNB test in the localisation of urinary tract infection in the child.
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An assessment has been made of renal growth and of the incidence of recurrent urinary tract infection in 116 children who had bilateral re-implantation of the ureters. Although reflux was prevented, 28% of the children continued to have infections long after the operation. The infections were mostly of the lower urinary tract whereas before the operation there was a significant incidence of acute pyelonephritis. After operation 82% of the kidneys grew normally and in 4,5% growth rate increased which is a smaller proportion than that reported in other series. In contrast 13,5% of the kidneys grew more slowly but they were usually abnormal radiologically before the operation.
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In 62 children presenting with a urinary infection, the immuno-fluorescent (I.F.) study of immunoglobulins fixed on the cell wall of urinary bacteria was performed jointly with the titration of serum antibodies towards the same bacteria. This study revealed that: 1. There was a correlation between I.F. and serodiagnosis in 82% of the cases. 2. There was a correlation between the localization of the urinary tract infection, as assessed by the classical biochemical means, and the results of I.F. and antibody measurements. Positivity of either I.F. or serodiagnosis, or of both tests, is significantly related with upper urinary tract infection wheras the negativity of the two tests is observed, at the exception of children under 1 year of age, in lower urinary tract infection. 3. There was a correlation between the site of infection and the results of I.F. and antibody measurements. In upper urinary tract infections, either I.F. or serological tests, or both are positive, whereas in lower urinary tract infections both tests are negative, except in children under the age of 1 year.
An acquired small kidney in a girl of 10 is reported. Interstitial pyelonephritis was the main cause for the shrinkage of the kidney, but very localised areas of renal dysplasia have also been found in this kidney, which happened to be completely destroyed in 34 months. In this meanwhile, the child had recurrent febrile urinary tract infections (clinically acute pyelonephritis). No malformation of the lower urinary tract was found in this child.
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The authors describe the technique used to detect the antibody-coated bacteria at the Hospital Trousseau (Paris). The presence of antibody-coated bacteria in 132 children with urinary tract infection is evaluated and compared to the serum antibody titres in 109 children of the same group.
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