Urinary Tract Infections in Children

Urinary tract infections occur when bacteria enter the urethra and travel up to the bladder or even the kidneys. Urinary tract infections in children can be very painful, but a brief course of antibiotics will usually clear the infection. If your child is exhibiting signs of a urinary tract infection, it is important for him to quickly see the doctor because an untreated infection can lead to permanent kidney damage.

Definitions

• A urinary tract infection is a bacterial infection of any part of the urinary tract including the bladder and kidneys. A urinary tract infection is called cystitis when it affects the bladder and polynephritis when it affects the kidneys. Doctors define a urinary tract infection in children as uncomplicated if it is a simple infection and complicated if it derives from an anatomical abnormality. Doctors also define a urinary tract infection based on whether it is a primary infection or recurrent.

Symptoms

• Symptoms of a urinary tract infection in very young children and babies may be nonspecific. Some symptoms include general irritability, vomiting, failure to thrive, and foul-smelling urine or diapers. Sometimes in young children the only symptom will be a fever. In older children, possible symptoms include burning or itching during urination, frequent urination, stomach pain, back pain and fussiness. A fever is possible, but is not always present.

Diagnosis

• Diagnosis of a urinary tract infection requires testing a urine sample. The doctor may collect this sample by placing a sterile bag over the child's penis or vagina, then waiting for the child to urinate. Bag collection is effective for boys, but often results in contamination of the sample for girls. Alternatively, your child's doctor may choose to use a catheter to collect the urine. A catheter is a thin plastic tube that is inserted through the child's urethra up to the bladder. The doctor's office will quickly test the urine for signs of infection. Your doctor will also send the urine sample to a lab where technicians will examine it microscopically and try to grow any bacteria in a culture to confirm the diagnosis.

Treatment

• For a primary, uncomplicated urinary tract infection, your child's doctor will likely prescribe a course of oral antibiotics for your child to take for five to seven days. Complicated or recurrent infections in children usually require a longer course of antibiotics. If your child does not show improvement after three to four days of treatment, call your doctor. Your child's urine should be re-tested three to four days after finishing his antibiotics to confirm that the infection has resolved.

Recurrent Infections

• Recurrent urinary tract infections in children can indicate a structural problem in the urinary tract. If your child has recurrent infections, his doctor may recommend further tests such as an ultrasound or a voiding cystourethrogram (VCUG) to examine your child's urologic anatomy and a follow-up appointment with a urologist. The doctor may also prescribe prophylactic antibiotics. Prophylactic antibiotics are low-dose antibiotics that are taken daily to help prevent another recurrence of infection.