{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:19:12Z","timestamp":1792685952812,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T00:00:00Z","timestamp":1565740800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The appropriate antimicrobial treatment period for febrile urinary tract infection (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>) can be changed, depending on whether the patient has acute focal bacterial nephritis (<jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content>). The aim of this study was to clarify the characteristics of <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content> compared with those of acute pyelonephritis (<jats:styled-content style=\"fixed-case\">APN<\/jats:styled-content>) and establish a strategy to detect <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 77 patients diagnosed with febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> were enrolled. They were divided into <jats:styled-content style=\"fixed-case\">APN<\/jats:styled-content> (<jats:italic>n<\/jats:italic> = 64) and <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content> groups (<jats:italic>n<\/jats:italic> = 13). The clinical data and other laboratory biomarkers were retrospectively analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The time required for fever resolution after antimicrobial treatment was significantly longer in the <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content> group than in the <jats:styled-content style=\"fixed-case\">APN<\/jats:styled-content> group (2.77\u00a0days vs 1.11\u00a0days, respectively, <jats:italic>P<\/jats:italic> &lt; 0.001). Also, the time to disappearance of pyuria after antimicrobial treatment was longer in the <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content> group than in the <jats:styled-content style=\"fixed-case\">APN<\/jats:styled-content> group (6.22\u00a0days vs 2.32\u00a0days, respectively, <jats:italic>P<\/jats:italic> = 0.001). Fever lasting &gt;1.75\u00a0days after antimicrobial treatment had a sensitivity of 92% and specificity of 79% for the detection of <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content>, while pyuria disappearance after 4\u00a0days had a sensitivity of 88% and specificity of 85%. When patients fulfilled both cut\u2010offs, the sensitivity and specificity were 89% and 97%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acute focal bacterial nephritis was associated with fever of significantly longer duration after antimicrobial treatment, and it took a longer time for pyuria to disappear. Children with febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> should be evaluated for <jats:styled-content style=\"fixed-case\">AFBN<\/jats:styled-content> if the fever persists \u226548\u00a0h after the initiation of antimicrobial treatment and if pyuria lasts for 4\u00a0days.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13910","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T07:59:24Z","timestamp":1565769564000},"page":"777-780","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Non\u2010invasive discrimination of acute focal bacterial nephritis with pyelonephritis"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8701-826X","authenticated-orcid":false,"given":"Hideharu","family":"Oka","sequence":"first","affiliation":[{"name":"Department of Pediatrics Asahikawa\u2010Kosei General Hospital Asahikawa Hokkaido 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