Pediatric Pyelonephritis Differential Diagnoses

Updated: Apr 25, 2022
  • Author: Patrick B Hinfey, MD; Chief Editor: Russell W Steele, MD  more...
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Diagnostic Considerations

UTI and pyelonephritis must be considered in young pediatric patients with fever and/or nonspecific symptoms so that this fairly common diagnosis is not overlooked. Identification and treatment of acute pyelonephritis in the first 5-7 days significantly decreases the risk of renal scarring.

Conditions to be considered in the differential diagnosis of pyelonephritis include the following:

  • Concurrent pregnancy

  • Anatomic abnormalities of the urinary tract

  • Vesicoureteral reflux

  • Ureteropelvic junction obstruction

  • Posterior urethral valves

  • Ureterocele

  • Vaginitis

  • Fever of unknown origin

  • Pelvic inflammatory disease

  • Xanthogranulomatous pyelonephritis

Differential Diagnoses