{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:11:25Z","timestamp":1753891885222,"version":"3.41.2"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Children with febrile urinary tract infections (UTIs) are prone to kidney scarring if they are not treated promptly; however, ambiguous symptoms before fever onset makes the early detection of UTIs difficult. Our study aimed to identify urethral discharge as an early manifestation in children with UTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled 678 children younger than 24 months with paired urinalysis and culture performed between 2015 and 2021; 544 children were diagnosed with UTIs. Clinical symptoms, urinalysis, and paired urine culture results were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Urethral discharge was observed in 5.1% of children with UTI and yielded a specificity of 92.5% for diagnosing UTI. Children with urethral discharge had a less severe UTI course, furthermore, nine of them received antibiotics before fever occurred and seven of them were free of fever during UTI course. Urethral discharge was associated with alkalotic urine and <jats:italic>Klebsiella pneumonia<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Urethral discharge is an early symptom in children with UTI; it may present before fever onset and help ensure prompt antibiotic intervention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1149218","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T08:02:07Z","timestamp":1687161727000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Urethral discharge as an early manifestation of urinary tract infection in children \u226424 months old"],"prefix":"10.3389","volume":"11","author":[{"given":"Nai-Wen","family":"Fang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Hsiang","family":"Ou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Shan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yee-Hsuan","family":"Chiou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1097\/INF.0b013e31815e4122","article-title":"Prevalence of urinary tract infection in childhood: a meta-analysis","volume":"27","author":"Shaikh","year":"2008","journal-title":"Pediatr Infect Dis J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1056\/NEJMoa021698","article-title":"Imaging studies after a first febrile urinary tract infection in young children","volume":"348","author":"Hoberman","year":"2003","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1542\/peds.2010-0685.","article-title":"Risk of renal scarring in children with a first urinary tract infection: a systematic review","volume":"126","author":"Shaikh","year":"2010","journal-title":"Pediatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1097\/00004872-200018040-00019","article-title":"Ambulatory blood pressure 16\u201326 years after the first urinary tract infection in childhood","volume":"18","author":"Wennerstr\u00f6m","year":"2000","journal-title":"J Hypertens"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2491","DOI":"10.1093\/ndt\/gfl216.","article-title":"Outcome of kidneys in patients treated for vesicoureteral reflux (vur) during childhood","volume":"21","author":"Lahdes-Vasama","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"B6","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1136\/bmj.299.6701.703","article-title":"Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up","volume":"299","author":"Jacobson","year":"1989","journal-title":"BMJ"},{"key":"B7","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1001\/jamapediatrics.2016.1181","article-title":"Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring","volume":"170","author":"Shaikh","year":"2016","journal-title":"JAMA Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/MOP.0b013e32834f0423","article-title":"Evaluation and management of urinary tract infections in the neonate","volume":"24","author":"Beetz","year":"2012","journal-title":"Curr Opin Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1542\/peds.102.2.e16","article-title":"Prevalence of urinary tract infection in febrile young children in the emergency department","volume":"102","author":"Shaw","year":"1998","journal-title":"Pediatrics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1542\/peds.2011-2856","article-title":"Association of malodorous urine with urinary tract infection in children aged 1 to 36 months","volume":"129","author":"Gauthier","year":"2012","journal-title":"Pediatrics"},{"key":"B11","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.jpurol.2020.02.001","article-title":"Childhood and adolescent idiopathic urethritis: what does the current literature say?","volume":"16","author":"Degheili","year":"2020","journal-title":"J Pediatr Urol"},{"volume-title":"Vaginitis. 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