Is your kid having a fever, but you can’t find any signs of cough or cold or any clear source of infection? However, is your child feeling tired, cranky, and less energetic than usual? Don’t overlook these unclear symptoms, as your little one might actually have a urinary tract infection. UTIs are a frequent occurrence during childhood. Although highly treatable, it is essential to identify them promptly. Neglected or untreated UTIs can pose a risk of kidney damage, especially in children under the age of six.
About Urinary tract infections
The urinary tract is made up of the kidneys, urinary bladder and the urethra. The kidneys are two bean shaped organs that lie against your spine in the lower back. When blood flows through your kidneys, waste products from your body are removed and passed down to two narrow tubes/ureters and stored as urine in the urinary bladder (a balloon like organ to store urine). When the bladder empties, urine is passed out of your body through a tube like organ called urethra. Opening of the urethra is the end of the penis in boys and in front of the vagina in girls.
Normal urine is usually sterile. A urinary tract infection is infection of the urinary tract or kidneys by bacteria/germs. While an infection can occur anywhere along this tract, the lower part consisting of the urethra and bladder is most commonly involved. Bacteria can enter the urinary tract and the urine from the skin around the rectum and genitals and by travelling up the urethra into the bladder. An infection of the kidney may develop if the bacteria travel further up to the kidneys through the ureters. Infections of the kidney are seen to be more serious than infections of the bladder. UTIs occur much more frequently in girls, because a girl’s urethra is shorter and closer to the anus. Uncircumcised boys younger than 1 year, are also seen to have a slightly higher risk of developing a UTI.
Causes
Bubble baths, tight fitting clothes, habit of holding urine for a long time, and girls wiping from back to front (instead of front to back) after a bowel movement are few of the things that can cause germs to pass into the bladder or kidney. Also, unhygienic conditions around the genital area, use of diapers, pin worms, bacterial diarrhea are some of the predisposing factors. Infection may be transmitted to the kidneys from the blood in kids and infants. Structural abnormalities in the urinary tract, problems such as vesicoureteral reflux (urine flows backward from the bladder to the ureters and kidneys when the bladder fills), and blockages to urinary flow in any part of the urinary tract can make a child more prone to urinary infections.
It is not unlikely for UTI to cause damage to the kidneys. UTI, especially that is associated with fever can affect the kidneys and leave behind permanent scars. Young children are at the greatest risk of kidney damage from UTIs. Damage may include kidney scars, poor kidney growth, reduced kidney function, and high blood pressure.
Symptoms and Diagnosis
Children with UTI may experience burning sensation or pain while urinating, frequent urination with small amounts of urine, fever, diarrhea, vomiting, stomach or back pain, bad smelling or bloody urine, irritability, and are less active. The child may also wet his/her clothes despite being potty trained.
Your doctor will usually suspect urinary tract infection if the child gets fever without accompanying symptoms of cough/cold or any focus of infection. The doctor may advise on getting a urinalysis (examining urine under the microscope to detect infection and pus) or a urine culture (technique that encourages bacteria to grow) in order to identify the type of bacteria that has caused the infection.
Treatment
The child needs to drink enough fluids as a routine to avoid the urine from getting concentrated and to wash out the bacteria by increasing the urine flow. Medications to treat UTI include antibiotics that are specific to the bacteria causing the infection. The doctor may prescribe antibiotics that can be taken orally, unless the infection is severe wherein he/she may need to be hospitalized for antibiotics to be administered through a vein. The child may be hospitalized for UTI if he/she has high fever/looks ill, is younger than 6 months, is dehydrated, or is vomiting. It is important to know that the child needs to complete the entire duration of treatment (usually 7 to 10 days) as prescribed by the doctor in order to ensure effective and complete cure.
Recurrent UTIs: Cause for concern
If a child suffers from recurrent UTI, then the child needs to be evaluated to rule out any physical problem in the urinary tract that is causing urinary infections. The child may need surgery to treat the problem or may have to take medicines on a continued basis if he/she has bladder or kidney problems that are causing repeated UTI.
If the child has about 2 to 3 attacks or more of UTI in a period of 6 months, then long term treatment with medicines may be necessary after the initial treatment with antibiotics for 7 to 10 days. He/she may need to undergo tests such as kidney and bladder ultrasound (sound waves that produce images of the kidneys and bladder to detect abnormalities), voiding cystourethrogram (examines the urethra and bladder when it fills and empties), intravenous pyelogram (liquid injected in to the vein travels down the kidneys and bladder and reveals possible obstruction), and imaging scans such as CT scan/ MRI scan or nuclear scans to diagnose underlying disease conditions causing recurrent UTI.
Preventive measures
UTIs can be prevented by dressing the child in loose fitting clothes (including underpants), avoiding bubble baths, and training the child to go to the bathroom several times a day and empty the bladder regularly. Girls should be taught to wipe themselves from front to back after using the bathroom to avoid spreading germs from the rectum to the vagina or urinary tract. Boys should be taught to wash the foreskin on their penis regularly, if they have not been circumcised. They should also wash the urinary parts with plenty of water each time they pass urine, in order to prevent infection from recurring. Strict aseptic precautions, treatment of thread worms, relief of constipation, changing of diapers frequently (or not using diapers) are also some of the preventive measures you can adopt.
Recognize UTI early
Urinary tract infection is infection of the kidneys or urinary tract by bacteria/germs that can keep recurring if not diagnosed properly and treated early. The risk of UTI throughout childhood is seen to be about 2 % in boys and a little higher at 8% in girls. UTI in children usually goes undiagnosed until later stages as the symptoms are not always obvious to the parents and younger children are not able to describe how they feel. Early recognition and prompt and effective treatment is important as untreated UTIs can lead to serious kidney problems.
