Thought It Was Just a Cold When My Child Had a High Fever... The Surprising Cause Found at the Hospital [Kok! Health]

If Recurrence Is Frequent, Investigate Vesicoureteral Reflux as a Potential Cause

Recently, Mr. A rushed to the emergency room because his child was experiencing a high fever and vomiting. Initially, he thought it was just a cold and decided to monitor the symptoms, but the fever did not subside and the child appeared increasingly lethargic. Alarmed, Mr. A quickly sought medical attention. After examination, the child was diagnosed with vesicoureteral reflux accompanied by acute pyelonephritis.

Sungseong Shim, Professor of Urology at Korea University Anam Hospital. Korea University Anam Hospital

According to the medical community as of May 9, children are prone to colds and febrile illnesses. However, if a child experiences repeated high fevers without cold symptoms, or appears lethargic and vomits, a urinary tract infection should be suspected rather than a simple cold. In particular, when vesicoureteral reflux occurs in children and is accompanied by a urinary tract infection, bacteria can ascend to the kidneys and cause acute pyelonephritis. If diagnosis and treatment are delayed, this can result in scarring of the kidneys, long-term decline in kidney function, or even high blood pressure.

Vesicoureteral reflux is a condition in which urine flows backward from the bladder up the ureter to the kidneys. In children, this is often caused by congenital factors, as the junction between the ureter and the bladder is not sufficiently mature. The condition itself may not present any special symptoms, but when accompanied by a urinary tract infection, bacteria can spread to the kidneys and cause acute pyelonephritis.

Pediatric urinary tract infections often show no distinct symptoms. Infants and young children are unable to express discomfort during urination or flank pain, so the only signs may be persistent high fever without cough or runny nose, poor appetite, or lethargy. For this reason, it is easily mistaken for a simple cold or gastroenteritis. However, repeated febrile urinary tract infections can be associated with kidney scarring, making early diagnosis and proper treatment crucial.

Major symptoms include unexplained repeated high fevers, vomiting, irritability, loss of appetite, changes in urine odor, blood in the urine, pain during urination, frequent urination, or inability to hold urine. In particular, if a child has a persistent fever without cold symptoms, or if a child who has previously had a urinary tract infection develops a high fever again, the possibility of a urinary tract infection should be considered. Diagnosis is first made by urinalysis and urine culture to confirm infection. If necessary, kidney and bladder ultrasounds, voiding cystourethrograms, and nuclear medicine tests are performed to assess the presence and severity of vesicoureteral reflux and the risk of kidney damage.

Treatment depends on the degree of reflux, the child's age, recurrence of infections, kidney condition, and whether there are voiding dysfunctions. If an infection is present, antibiotics are administered. If the reflux is mild or likely to improve as the child grows, regular follow-ups may be recommended. In contrast, if the reflux is severe, if febrile urinary tract infections are recurrent, or if there is a high risk of kidney damage, preventive antibiotics, endoscopic injection therapy, or surgical treatment may be considered.

Sungseong Shim, Professor of Urology at Korea University Anam Hospital, stated, "Pediatric vesicoureteral reflux is one of the more commonly detected congenital urinary tract disorders, but early diagnosis and proper management can reduce the risk of kidney damage. Especially in infants and young children, if unexplained high fevers are repeatedly observed, it should not simply be dismissed as a cold, and a thorough evaluation including a urinalysis is necessary."

He added, "In some children, vesicoureteral reflux may improve naturally as they grow, but if febrile urinary tract infections recur during that time, kidney damage can occur. Caregivers should pay close attention to changes in the child's body temperature, urination patterns, appetite, and energy levels, and seek prompt medical care if any abnormal signs are detected."

This content was produced with the assistance of AI translation services.