Urinary Tract Infections in Children
Do children develop urinary infections?
Urinary tract infections (UTI's) do occur in children and even babies. The cause of a urinary tract infection is a bacteria in the urine and bladder. The bacteria can potentially infect the kidney or even enter the blood. In babies, the immune system is not as strong so the potential complications may be quite serious.
What are the symptoms?
The symptoms, causes and possible complications depend on the age of the child. Generally, the younger a child is, the less specific the symptoms are. Symptoms of a UTI in older children and adults include pain on urination, frequent urination and new onset of bedwetting. Other less frequent symptoms include blood in the urine, abdominal pain, and sometimes a low-grade fever. Symptoms indicative of a kidney infection, known as pyelonephritis, are back pain, high fever, chills and sometimes vomiting. In younger children and babies the symptoms are even less specific and may include only fever, increased irritability decreased feeding, diarrhea and/or vomiting.
What tests can confirm a urinary infection?
The only way to determine whether or not a child has a UTI is to do a urine test. Collecting urine from a baby is a challenge. A commonly used technique is to attach a plastic bag around a child's genitalia and wait until the child voids into the bag so that the urine can be analyzed. Another way of obtaining urine is by a catheter - a small tube inserted into the child's urethra. Once collected, the urine is analyzed and examined microscopically in order to confirm the presence of infection. The definitive test however, to confirm a UTI is to send the urine for a culture. This takes 24-48 hours and will confirm the presence of a bacterial infection in the urine.
How are urinary infections treated?
The treatment of a UTI is antibiotics. Which one, how it is administered and for how long, depend on the age and history of the child as well as how sick a child with a suspected UTI looks. Certainly in young or sick looking children, doctors will not wait for the 24 - 48 hours for the culture results before starting treatment. If the initial analysis is abnormal and suggestive of a UTI, treatment will be started before for the culture results come out.. In young babies, children who are vomiting or children with a suspected kidney infection the antibiotics are given intravenously in hospital. Usually, older children, who are not sick looking and have no evidence complications are treated with antibiotics given by mouth.
Are other test needed?
The other issues in children with a UTI are possible underlying kidney or bladder abnormalities. It is for this reason that most young children with a UTI, especially boys, need special tests to ensure that there are no kidney or bladder problems. Typically a kidney ultrasound is performed, which can tell us about the kidney, bladder, and urinary system in general.
If the ultrasound reading is not normal, depending on the results and the specific situation, another test may be needed. It is called a voiding cystourethrogram (VCUG). This test determines whether the connection between the kidneys and the bladder—the ureters—work well or not. If there is an abnormality detected, this means that children will be prone to getting repeat infections. The treatment of these anomalies, such as abnormally shaped kidneys, an abnormal collecting system, and a urinary flow known as vesicoureteral reflux, ranges from taking preventative antibiotics daily to an operation to repair the congenital abnormality. In certain situations other tests may also be necessary to assess how the kidneys are working and to what degree they may be blocked.