URINARY TRACT INFECTION AMONG CHILDREN WITH FEBRILE CONVULSION AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

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URINARY TRACT INFECTION AMONG CHILDREN WITH FEBRILE CONVULSION AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

Abstract

Urinary tract infection and febrile convulsion are two common morbidities
in children. Though both have been studied extensively there is paucity of data on
the co-existence of both morbidities, especially in Nigeria. This work was
undertaken to study urinary tract infection among children with febrile convulsion.
A descriptive cross-sectional study of urinary tract infection among children with
febrile convulsion aged 6 months to 5 years was carried out. One hundred and forty
five children with febrile convulsion were recruited consecutively. Socio
demographic, clinical information and urine samples were obtained and dipstick
urinalysis, microscopy, culture and sensitivity were done. Urinary tract infection
was found among 15 (10.3%) of the 145 children with febrile convulsion. Far more
males were involved than females (8.3% Vs 2.1%) even though the gender
difference was not statistically significant (χ2 = 1.423, p = 0.233). Complex febrile
convulsion was a statistical significant finding among the children with urinary
tract infection (χ2= 5.220, p= 0.022). The bacterial pathogens isolated were
Escherichia coli (46.7%), Klebsiella spp (33.3%) and Staphylococcal aureus
(20%). No presenting symptoms were discriminatory enough to identify the child
with both febrile convulsion and UTI. Dysuria and abdominal pain however,
showed high specificity and negative predictive value (> 90%) indicating they may
be considered as important negatives of UTI in children with febrile convulsion.
Seventy nine percent of the urinary isolates were sensitive to ciprofloxacin and
ofloxacin while 52% of the isolates were sensitive to ceftriaxone. However more
than 50% of the isolates were resistant to ceftazidime, cefuroxime, clavulanic acid
potentiated amoxicillin and gentamycin. In conclusion, UTI is common among
children with febrile convulsion, though a cause-effect relationship could not be
ascertained. A high index of suspicion should be entertained in those children with
complex febrile convulsion. Treatment of UTI in such children could be
commenced using empirically ciprofloxacin, ofloxacin and ceftriaxone. However
caution should be exercised with use of the flouro-quinolones in children.

URINARY TRACT INFECTION AMONG CHILDREN WITH FEBRILE CONVULSION AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

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