Urinary tract infections are relatively common in children. They occur more often in girls than in boys after age one year old although UTIs are more in boys under the age of one year.

It can be difficult to determine if your child is suffering from a urinary tract infection. If you think your child may be suffering from a UTI, it is important to seek medical attention.

UTI can also spread from the bladder to the kidneys, leading to a much more serious UTI as a kidney infection (pyelonephritis).

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Causes of UTIs

UTIs develop when normal bacteria on the skin around the rectum and genitals make their way into the urinary tract and multiply. The bacteria can settle in a number of areas, such as the kidneys, bladder, urethra, or ureters. Girls are more susceptible to UTIs than boys after age 1 year and then girls are more likely to get UTIs. Uncircumcised boys are more likely to get UTIs than circumcised boys, but treating a tight foreskin can reduce the likelihood of getting a UTI.

There are some congenital conditions can make some children more likely to develop UTIs.

  • Blockage of the flow of urine, due to a narrow connection between the kidney and the ureter ( ureteropelvic junction or UPJ) or the ureter to the bladder (ureterovesical junction or UVJ), ureterocele or urethral stricture, may make bacteria more likely to  grow in the bladder or kidneys and cause a UTI.
  • Vesicoureteral reflux or VUR, may allow urine to back up into the kidneys and ureters from the bladder. This constant back up of urine can make  bacteria to grow in the bladder and travel easily to the kidney causing a kidney infection.
caring-for-patient-with-urinary-tract-infection-Dr.-Elias-Wehbi

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Symptoms of a Urinary Tract Infection

  • Fever
  • Pain or burning with urination
  • More frequent urge to urinate, more frequent urination and new wetting of the underwear or bed where your child has been dry.
  • Back or abdominal pain
  • Younger children often do not present with these other symptoms. They may develop a fever, be unusually fussy or irritable, refuse to eat or have poor growth as an infant.

If you believe your child may have a UTI, it is important to seek medical attention. A UTI can spread rapidly and requires medical treatment.

bacteria-contributing-to-urinary-tract-infection-Dr.-Elias-Wehbi

Diagnosis

Your doctor will get a sample of your child’s urine to test  for signs of infection such as finding  bacteria and white blood cells in the urine sample.  The lab test of the urine will look for these signs and see if there is any specific bacteria that is causing an infection.  This test is called a urine culture. This helps your doctor select the right treatment or antibiotic for your child.

If your child has recurrent UTIs, your doctor may want to look for problems that make your child more likely to have recurring infections and may perform a variety of imaging tests. An ultrasound of the kidneys and bladder will generally be done to show if there are any problems with the kidneys and bladder that may have caused your child’s UTI.

A voiding cystourethrogram may also be done to show problems in the bladder or urethra when your child voids or if VUR is present.

Recurrent UTIs are very common in children who are toilet trained but do not urinate often enough, do not empty their bladders completely, do not drink enough to flush out bacteria,  or do not relax when urinating.  Many children with urinating problems also have problems with constipation, which increases the amount of local bacteria near the urethra that can cause UTIs.

Treatment of UTIs

The most common treatment for a UTI is antibiotics. Your child will probably have to take the medication for several days as recommended by your child’s doctor, and it may be necessary to perform another urine test at the end of the medication cycle to be sure the infection is cleared up. It is important to completely treat the infection by giving your child all of the antibiotics that their medical provider has recommended. If you stop the treatment before it is completed, the UTI may come back and may not be as easy to treat as the original infection.

If your child is very sick with a high fever, is unable to keep fluids down or eat, the antibiotics may have to be given either blood or by an injection in the muscle or by placing the antibiotics in the bloodstream.

It is import to treat UTIs as these infections can damage the kidneys and could spread to other parts of the body like the bloodstream.