Urinary Tract Infections in Children

A urinary tract infection (UTI) can occur in any part of the urinary tract: the kidneys, ureters (tubes that connect the kidneys to the bladder), the bladder and the urethra.  Normally, urine in the kidneys, the ureters and the bladder doesn't contain any bacteria (germs). Bacteria are normally present only at the very end of the urethra and on the skin around the opening of the urethra. The bacteria that are normally present around the urethra don't usually cause an infection. However, when harmful bacteria get into the urinary tract, typically at the opening, they may cause an infection.  For example, if bacteria get into the child's bladder, they can cause a bladder infection or "cystitis." The child might have a burning feeling when s/he urinates. The child may also have a constant feeling of bladder fullness. Cystitis can cause loss of bladder control and seldom creates a fever. An infection can spread to the kidneys causing "pyelonephritis," which is more serious and can potentially cause permanent harm to an infected kidney. Usually, a kidney or renal infection causes a fever with back pain and general fatigue.

Due to an infant's inability to tell you symptoms, it can be difficult to diagnosis either a bladder or kidney infection. However, an unexplained fever lasting several days, urine discoloration or appetite loss suggests the possibility of a UTI.  In older children, symptoms of back pain, urge to urinate repeatedly, nausea, and vomiting or persistent fatigue suggest urinary tract infection is possible.

Pain with urination or loss of urine control can be caused by factors other than UTIs. For example, tight underwear or leotards, bubble baths, or dirty diapers or underpants can irritate the tender skin around the urethra and cause pain. However, dirty diapers and dirty underwear don't cause a UTI.  If a child is suspected of having a UTI, a urinalysis (looking for bacteria and infection- fighting white blood cells) and a urine culture (looking for the bacteria) are typically performed. Pending the results, antibiotics will be prescribed.

Because UTIs can exist without clear symptoms and some antibiotics may not fully resolve an infection, it is important that your child has a follow-up urinalysis after antibiotic treatments to ensure complete resolution of the infection.

Perhaps the most important prevention is to ensure the child's urethra avoids contact with bacteria. This is mostly accomplished by changing diapers to avoid prolonged wearing of dirty diapers and by teaching proper cleaning habits. These include proper front-to-back wiping in girls after urination, avoiding tight-fitting undergarments, preventing constipation and encouraging voiding as soon as the urge is present. From Medical Capsule by Gregory N. Larkin, M.D.

Edited by Dr. Sreenivasarao Vepachedu, 09/25/98

Back to The Telangana Science Journal
Back to Vepachedu Home Page