Click on the icon on the upper right hand side for the article by Ori Toker, MD, Shepard Schwartz, MD, Gershon Segal, MD, Nadia Godovitch, MD, Yechiel Schlesinger, MD and David Raveh, MD.
IMAJ 2010: 12: May: 262-265
Background: Ritual circumcision in neonates may cause a urinary tract infection within 2 weeks of the procedure.
Objectives: To evaluate the prevalence of urinary tract infection among Jewish male circumcised neonates (¡Ü 28 days old) evaluated for fever in the emergency room.
Methods: All available medical records of neonates presenting to the pediatric emergency room for evaluation of fever over a 10 year period were reviewed. Data included gender, ethnic background, age in days on presentation to the emergency room, age in days when circumcision was performed (in males ¡Ý 8 days of age), and results of urine, blood and cerebrospinal fluid cultures. Families of males older than 8 days of age who had a UTI were contacted by telephone to verify the circumcision status when the infant presented to the ER, to ascertain whether the circumcision was performed ritually by a mohel* or by a physician, and, when not recorded in the chart, to verify the day of life on which circumcision was performed.
Results: Among neonates older than 8 days of age, 60 (24.7%) of the 243 febrile Jewish males had a UTI, as compared to 12 (8.4%) of 143 females (P < 0.0001). In 39 of 54 male neonates (72%) for whom circumcision was performed ritually on the eighth day of life, UTI occurred within 9 days of the circumcision. For females, there was no such clustering of UTI cases in the second week of life, nor during any other time period.
Conclusions: Febrile male neonates who have undergone ritual circumcision have a high prevalence of UTI and must be evaluated and treated accordingly.
 UTI = urinary tract infection
 ER = emergency room
* Mohel is a Jewish man trained in the practice of Brit milah (circumcision).