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October 1994

Overwhelming Escherichia coli Sepsis in Ureterovesical Junction Obstruction Without Reflux

Arch Pediatr Adolesc Med. 1994;148(10):1102-1103. doi:10.1001/archpedi.1994.02170100100021

Congenital anomalies now account for a large percentage of infant deaths.1 Clinically significant congenital anomalies of the genitourinary tract are relatively common. A study from Buffalo, NY, in 1988 demonstrated that 1.37% of unselected, otherwise healthy infants will have a urinary tract anomaly seen on ultrasonography that may require operative repair.2 The first clinical manifestation of many genitourinary anomalies is a urinary tract infection (UTI) during infancy, which presents as fever, vomiting, or irritability.3 Even when detected early, these anomalies can sometimes result in significant early morbidity or death. This is demonstrated by the following case report.

Patient Report. A 24-day-old male infant was born by a scheduled cesarean section at 36 weeks' gestation with rapidly worsening congenital hydronephrosis of the left kidney. He was evaluated on the 18th day of life with abdominal ultrasonography, vesicoureterography, and a renal scan. Ultrasonography revealed severe congenital hydronephrosis of the