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
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