RSV, UTI and Vesicoureteral Reflux: Sydney's Story

The first year of life was rough for little Sydney. When she was just 5 months old, she was hospitalized for five days for respiratory syncytial virus (RSV), an infection of the lungs and breathing passages.

Then, at 8 months old, she developed a serious urinary tract infection (UTI).

“She was breathing really fast, and then I noticed she had a fever,” her mother Lauren says. “Because she had similar symptoms when she had RSV, I thought she might have gotten it again. I didn’t know what was wrong. I was very nervous.”

Lauren rushed Sydney back to the hospital that had treated her for RSV. She was evaluated and diagnosed with the UTI, given antibiotics and kept overnight. Though Sydney responded well to the antibiotics, further tests of her kidneys and urinary tract concerned physicians at the hospital.

Referred to CHOP 

They referred her to Children’s Hospital of Philadelphia (CHOP), which is consistently ranked among the best in the nation in urology by U.S. News & World Report. Each year CHOP’s pediatric urology program treats almost 20,000 children from the Philadelphia area and around the world.

The CHOP Specialty Care Center in King of Prussia, PA, has a urology satellite clinic staffed by CHOP urologists, which provided the family with the same diagnostic workup available at CHOP’s Main Hospital but at a more convenient location.

A voiding cysto-urethrogram (VCUG) — an evaluation of Sydney’s bladder and urethra, the small tube that connects it with the outside of the body — found low-grade vesicoureteral reflux (VUR), a condition in which some urine flows back into the kidneys. In conjunction with UTI, bacteria can move into the kidney and cause dangerous infection and scarring.

Appropriate testing

In the past, urologists might have been quick to do extensive radiological studies and even surgery for this condition. But the high volume of patients with UTIs CHOP has seen and followed over decades has helped advance the team’s understanding of VUR.

“We’ve been able to isolate which kids are at higher risk and which are not. That means we can effectively follow kids like Sydney without exposing them to unnecessary tests or procedures,” says Thomas Kolon, MD, CHOP attending urologist.

Renal ultrasound scans to evaluate the kidneys are a key component of this approach. Fortunately, Sydney’s scans were fine, and she was prescribed low-dose antibiotics for a year as a preventive measure. She visited CHOP’s Main Hospital a year later for follow-up with Dr. Kolon, when a new VCUG found the reflux had resolved on its own.

Thankful for the care she received

Sydney is now a fun-loving, potty-trained 3-year-old who loves being a big sister to 8-month-old Carly. Since her experience at CHOP, she’s had nothing worse than a cold, and Dr. Kolon expects she will be just fine going forward.

Her mom is very thankful for her good health and CHOP’s network of top doctors.

“When they’re so little, they’re so fragile,” Lauren says. “Feeling like she’s in good hands is really nice. Everyone, the pediatricians at the CHOP Care Network and the people we saw down in Philly, were all wonderful.

"They really explained the diagnosis and how it could affect her, and I appreciate that because a lot of times with medical stuff it can be kind of confusing. They drew me a picture and explained everything to me," Lauren says. "I couldn’t have asked for it to go better.”

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