Urinary Tract Infections in Children

Urinary tract infection can be awful for the child and very worrying for the parents. Babies and infants do not demonstrate the usual symptoms of UTIs, present with high fever and irritability and frequently are diagnosed after a number of days.

Mostly oral antibiotics are required but sometimes your child needs to be hospitalised for intravenous antibiotics. However even when your child has recovered they will still require investigation to check there is no underlying cause for the infection.

Here at London Children’s Surgery we have a sensible recognised program to investigate your child. If we can avoid a stressful test for your child we will do everything possible to do so. Our aim is to keep your child happy and healthy and to demonstrate to you what caused the infection and what we can do to prevent them occurring again.

Symptoms

In younger children it can be very difficult to determine any symptoms for urinary tract infection. In older children they can present with the more classical symptoms of urinary tract infection just as pain, high fever, fowl smelling urine, pain on voiding, frequency, rushing to the toilet and urinary incontinence.

Causes

Urinary tract infection is really common in children. The vast amount of UTI generally occurs within the bladder and a small number occur within the kidney. The most commonly found bacterium to cause infection within the bladder is Escherichia coli (E. coli).

Treatments

A vast majority of children are suitable to be treated with antibiotics, however further investigations maybe required. Investigations that are useful can be, depending on the child and the symptoms, are at least an ultrasound scan. Occasionally a bladder function assessment which is a non invasive bladder ‘MOT,’ a DMSA scan which is a nuclear medicine test which will identify kidney scarring and occasionally a micturating cystourethrogram (MCUG) is useful for determining what the internal anatomy is like.

Investigations

Urinary tract infections can be quite problematic for children. If the infection moves the bladder to kidneys, they can cause significant damage. The child could have prolonged sickness and stay in hospital. The kidney tissue itself can be damaged and the overall function of that kidney can be reduced. The child could also become septic. Some children, when they have complex urinary anatomy, may have urinary tract symptoms or urinary tract infection and have a negative urinary test. In that situation it would be very wise to perform an ultrasound scan.

FAQ’s

Urinary tract infection is really common in children. The vast amount of UTI generally occurs within the bladder and a small number occur within the kidney. The most commonly found bacterium to cause infection within the bladder is Escherichia coli (E. coli).
Girls do get more urinary tract infection than boys. It’s believed this is due to the fact girls urethra, which is the outflow pipe from the bladder to the skin is much shorter which makes is easer for bacteria to ascend into the bladder. However, the presence of one urinary tract infection in a child should not be ignored and investigations are useful in order to outrule abnormality of the urinary tract itself.
In younger children it can be very difficult to determine any symptoms for urinary tract infection. In older children they can present with the more classical symptoms of urinary tract infection just as pain, high fever, fowl smelling urine, pain on voiding, frequency, rushing to the toilet and urinary incontinence.
If you have any concerns you should bring your child to the GP. A urine specimen should be taken and sent to the lab for microscopy. The best urine to take for urinalysis is a midstream urine, which means your child starts to void and in the middle of the stream, a sample of urine is taken.
A vast majority of children are suitable to be treated with antibiotics, however further investigations maybe required. Investigations that are useful can be, depending on the child and the symptoms, are at least an ultrasound scan. Occasionally a bladder function assessment which is a non invasive bladder ‘MOT,’ a DMSA scan which is a nuclear medicine test which will identify kidney scarring and occasionally a micturating cystourethrogram (MCUG) is useful for determining what the internal anatomy is like.
Very rarely is surgery required for children with urinary tract infections and only when there is a distinct problem which is best treated by an operation.
Urinary tract infections can be quite problematic for children. If the infection moves the bladder to kidneys, they can cause significant damage. The child could have prolonged sickness and stay in hospital. The kidney tissue itself can be damaged and the overall function of that kidney can be reduced. The child could also become septic. Some children, when they have complex urinary anatomy, may have urinary tract symptoms or urinary tract infection and have a negative urinary test. In that situation it would be very wise to perform an ultrasound scan.

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Mr. Feilim Murphy

MB, BCH, BAO, FRCSI (Paeds)
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