Acute pyelonephritis in the pediatric emergency department: outpatient management or hospitalization?

Acute pyelonephritis (AP) is the most serious bacterial illness of childhood that involves renal parenchyma. The most common germ involved in AP is E. Coli (80-90% of the cases). High temperature over 38°C is a sign of renal parenchyma involvement. It may be associated with other clinical symptoms (vomit, abdominal pain, inappetence, dysuria). AP treatment should be initiated after urine analysis and the diagnosis confirmed by culture. This article reviews the difference between outpatient and nosocomial urinary tract infections patients. A comprehensive search of published literature was carried out to identify all articles published on this topic in English and Italian from 2000 to 2020. Key terms used are Acute pyelonephritis, Childhood, Pediatric Emergency Department, Urinary Tract Infection.