Urinary tract infections in children
|AGE Not significant factors||GENDER Overall more common in girls|
|LIFESTYLE Not significant factors||GENETICS Sometimes run in families|
These are infections of the child's urinary tract, which may lead to kidney damage.
Urinary tract infections develop when bacteria, normally present around the anus, pass up the urethra (the passage from the bladder to outside the body) and infect the bladder (see Cystitis) or kidneys (see Pyelonephritis). Less commonly, a bacterial infection may be carried to the urinary tract in the bloodstream. Most urinary infections are easily treated, but they may scar the kidneys, increasing the risk of further infection, so treatment must be prompt. Urinary infections tend to be more common in girls, although newborn boys are more susceptible than newborn girls.
The kidney infection pyelonephritis is more common in children who have urinary reflux. In this condition, there is an abnormality of the ureters (the passages from the kidneys to the bladder) where they open into the bladder. This abnormality results in a small amount of urine flowing back up the ureters towards the kidneys when the bladder is emptied. Urinary reflux sometimes runs in families, suggesting a genetic factor.
What are the symptoms of urinary tract infections in children?
If your child is under the age of 2, he or she may be unable to describe any specific symptoms, but you may notice:
- Vomiting and/or diarrhoea.
- Irritability or drowsiness.
Older children often have more specific symptoms and can explain how they feel. In addition to the symptoms of young children, an older child may have:
- Frequent, urgent need to pass urine.
- Burning sensation on passing urine.
- Pain in the lower abdomen or side.
- Bedwetting or daytime wetting after a period of dryness.
If you suspect that your child has developed an infection of the urinary tract, you should consult the doctor at once.
What might be done?
The doctor will test a urine sample for evidence of infection. If the test indicates a possible infection, your child will be treated at once with antibiotics. The sample will be sent for laboratory testing to identify the bacteria responsible. The antibiotics may be changed when the results are known. If the symptoms suggest pyelonephritis, your child will probably be treated in hospital with intravenous antibiotics and fluids.
Your child may need to have radionuclide scanning (see DMSA scanning) or ultrasound scanning to look for scarring in the kidneys or other abnormalities of the urinary tract. A specialized X-ray to check for urinary reflux may also be carried out. In this procedure, a dye is introduced into the bladder through a narrow tube. X-rays are then taken as the child passes urine. A child with urinary reflux will be given low-dose antibiotics long-term until the kidneys are no longer at risk. In severe cases, surgery may be needed.
With treatment, most children with a urinary tract infection make a complete recovery. However, infections may recur and should always be investigated. If untreated, recurrent infections due to reflux may cause permanent kidney damage.
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