Illnesses

Urinary tract infections

Infections in the urinary tract occur when bacteria attacks the parts of the body that store or eliminate urine, like the bladder or urethra, the tube that carries urine from the bladder to the outside of the body. These are called lower tract infections. Infection in the bladder is called cystitis; infection in the urethra is called urethritis. If infection involves the kidneys, we call it a kidney infection or upper tract infection.

A very small percentage of newborns, about one in 1,000, develop urinary tract infections. They occur more frequently in children: about 1 percent of boys and 3 percent of girls develop urinary tract infections.

What causes them
They usually result from bacteria outside the body entering the urethra. A small percentage result from abnormalities in the structure or function of the child's urinary tract, such as a blockage in the flow of urine or a backward flow of urine from the bladder to the kidneys. Usually the cause in girls is wiping with toilet paper from back to front, spreading germs from the anus to the urethra. Certain perfumed bath products may also irritate a child's urethra. Sexually active adolescents report more cases of cystitis than average.

What to look for
Symptoms in an infant include a fever that doesn't go away. The child may be irritable, lose his or her appetite and vomit.

Older children also develop fevers and may report a stinging or burning sensation while urinating. They may urinate more frequently than usual, wet the bed and pass very strong smelling urine. If the infection involves the kidneys, the child may report back pain in the middle of his or her back or abdominal pain. Chills and fatigue are often associated with kidney infection.

What to do
Take your child to the doctor. The doctor will take a sample of your child's urine, which will be tested for signs of infection. Lab tests will indicate what kind of bacteria are causing the infection, which will help your doctor prescribe an antibiotic that will be most effective in destroying the bacteria. After several days of treatment with antibiotics, your doctor may examine another urine sample to make sure the infection is gone.

The majority of children are treated as outpatients in their doctors' offices. In special cases, a child may need to be admitted to the hospital for treatment. This may happen if the child is younger than six months old, if there are signs of a kidney infection or if bacteria from the urinary tract have spread to the child's bloodstream. Also, a child who is dehydrated, has high fever and chills or is vomiting repeatedly may be treated in the hospital.

Urinary tract infections usually are cured within two weeks, but your child may develop another infection in the future. If a child has repeated urinary tract infections, the doctor may suspect abnormalities in the structure of the child's urinary tract. The doctor may order additional tests and may refer you to see a urologist, a doctor who specializes in urinary tract diseases.

What to do at home
Give prescribed antibiotics to your child according to your doctor's instructions. Take your child's temperature each morning and evening and call your doctor if it rises above 101 degrees F. Encourage your child to drink lots of beverages, but avoid products with caffeine such as coffee, tea or cola drinks.

When to call your doctor

• If your child reports pain when urinating, wets the bed after having been potty trained, or has strong smelling urine.
• If the child has a fever that doesn't respond to home treatment and complains of pain in the abdomen or back.
• If any infant under three months of age has fever over 101 degrees F.

• YNHH Health Library: Urinary tract infection

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Reviewed: Robert LaCamera, MD
Last revised: June 7, 2007 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.