Urinary tract infection in children

Infections involving the various parts of the urinary tract namely kidneys, ureter, urinary bladder and urethra, are common in children.

Urinary tract infection (UTI) can cause many symptoms like fever, pain while passing urine or abdominal pain.

Often there may be only one symptom. Non-specific symptoms like nausea and vomiting are also common. Occasionally the urine may be foul smelling. Some children may present with symptoms not directly related to the urinary tract-for example with diarrhea (parenteral diarrhea).

The diagnosis can be confirmed by the laboratory examination of urine including culture. Urine may contain excess of protein and microscopic examination may show many white blood cells.

Collection of urine: In older children a midstream specimen can be easily collected. The urine is collected after the child has passed some urine in order to minimize contamination.

For collecting urine in a small baby a special bag is available. It is attached to the perineum is such a way that the hole in the bag is placed over the genital organ. When the baby passes urine it collects in the bag, which is then removed and given to the laboratory.

Treatment: Most of the children with U T I can be treated as outpatients. But those with infection of kidneys having high fever may require hospitalization and intravenous medication. Frequent vomiting may also necessitate admission and intravenous medication.

It is important for parents to know that sometimes an obstruction somewhere in the urinary tract can predispose a child to repeated urinary tract infection.

Obstruction can occur at various levels, between a kidney and ureter, within the ureter, at the junction of ureter with the bladder and the urethra.

During the first year of life the incidence of urinary tract infection is almost same in boys and girls. After one year it is more common in girls than boys.

Obstruction in the urinary tract is more common in boys than in girls. Hence one attack of urinary tract infection in a female child need not cause any alarm but recurrent attacks of urinary tract infection should be investigated.

But in male children even one attack of urinary tract infection requires investigation for any obstruction. Usually an ultrasound examination of the abdomen is sufficient.

This can reveal whether the kidneys and ureters are of normal size or enlarged-a sign of obstruction somewhere.

But in some children more sophisticated investigations may be required. It is very important to correct any obstruction in the urinary tract at the earliest because repeated infections can cause permanent damage to one or both kidneys.

Sometimes when a child passes urine some of it may go up into the ureters a condition know as vesicoureteric reflux. This condition can be diagnosed by an investigation called micturating cysto urethrogram.

Any child with this condition needs regular follow up. Antibiotics to prevent infection have to be given for a long time. Mild reflux may resolve over a period of time. If the reflux is severe surgical correction may be required.

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