Urinary Tract Infections in Children

Urinary tract infections (UTIs) in children are classified into two types based on the infection's location:

• Pyelonephritis In children, this condition is characterized by high fever, flank pain, cloudy urine, painful urination, and nausea/vomiting. However, symptoms in younger children may be nonspecific, such as high fever, irritability, and decreased feeding. Infants should undergo urine testing whenever they have a fever and no apparent abnormalities on physical examination.
• Cystitis Symptoms include painful urination, frequent urination in small amounts, urgency to urinate, cloudy urine, and sometimes blood in the urine, often as droplets at the end of urination. In severe cases, small blood clots may be found in the urine. Some children may experience new-onset bedwetting after having previously been toilet trained.

Diagnosis of Urinary Tract Infections in Children

     Diagnosis is made through urinalysis and urine culture, which may reveal white blood cells or bacteria in the urine.

     Culturing the urine can identify the type of bacteria causing the infection and assess its response to antibiotics. Since UTIs can indicate underlying congenital abnormalities of the kidneys and urinary tract, further investigations are warranted in all cases of pyelonephritis or recurrent cystitis in young children. These may include ultrasound, catheterization to check for vesicoureteral reflux, and a DMSA scan to detect kidney scarring.

Treatment of Urinary Tract Infections in Children

     UTIs in children can be treated with antibiotics. Children with high fever, dehydration, or who cannot take medications orally should be hospitalized for intravenous antibiotics. Treatment duration is typically 10-14 days for pyelonephritis, while cystitis usually requires a shorter course of about 5-7 days.

Preventive Measures for Urinary Tract Infections

• Hygiene After Bowel Movements In girls, wipe from front to back to avoid introducing bacteria from the stool into the urinary tract.
• Stay Hydrated and Urinate Regularly Children should drink plenty of fluids and urinate every 3-4 hours. Avoid holding urine, as retained urine can promote bacterial growth.
• Avoid Constipation Establish a regular bowel movement routine.
• Avoid Irritation Steer clear of tight clothing and avoid using irritants like bubble baths that can affect the urethra.

Urinary tract infections can indicate congenital abnormalities of the kidneys and urinary tract, so children should undergo further special evaluations as needed.