Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach

Abstract

Background: Urinary tract infections (UTIs) are considered common facilitating factors along with other infections in triggering febrile seizures (FS). The main purpose of our study was to identify specific patterns of UTIs, using a combination of inflammatory biomarkers, in order to differentiate UTIs from other bacterial diseases triggering FS. Method: This study included a number of 197 distinct FS events from patients hospitalized in the Pediatric Clinical Hospital Sibiu, among which 10.2% were diagnosed with UTIs. Results: In one-third of the patients with UTI, the symptoms were limited to fever and FS. Using Two-Step cluster analysis, a distinct inflammatory pattern has emerged: higher platelet distribution of the population (PDW), platelet large cell ratio (P-LCR), mean platelet volume (MPV), C-Reactive Protein (CRP), and neutrophil to lymphocyte ratio (NLR). This pattern was associated mainly with bacterial lower respiratory infections. UTIs were highly unlikely in the patients with significantly increased CRP values and normal values of platelet indices. Conclusion. Considering the nonspecific clinical picture of UTIs at an early age, to optimize the management of FS, a fast diagnosis of UTI is mandatory. Our study suggests that analyzing the inflammatory biomarkers interlinks (rather than individual parameters) could help identify even oligosymptomatic UTIs patients.

Keywords

• febrile seizures
• urinary tract infections
• inflammatory biomarkers
• cluster analysis
• laboratory data
• C-reactive protein