Urinary tract infection (UTI) is a common problem in children with short term and long term health problems.
Why do urinary tract infections require urgent attention and immediate treatment in children compared to adults?
Children with urinary tract infection need immediate attention because:
- UTI is a common cause of fever in children and ranks third among the most common infections in children after respiratory tract infection and diarrhea.
- Inadequate and delayed treatment may cause permanent kidney damage. Recurrent UTI causes kidney scars that in the long term can lead to high blood pressure, poor kidney growth and even chronic kidney disease.
- Because of its variable presentation, diagnosis of UTI is often missed. A high index of vigilance and suspicion are necessary for its diagnosis.
- There is a high risk of recurrence.
What are the predisposing factors for urinary tract infections in children?
The following are common risk factors for UTI in children:
- Having a shorter urethra makes UTI more common in girls.
- Wiping from back to front (instead of front to back) after coming from the toilet.
- Structural abnormality of the urinary tract (e.g. posterior urethral valve).
- The presence of congenital urinary tract anomalies such as vesicoureteral reflux (condition with an abnormal backward flow of urine from the bladder up the ureters and toward the kidneys) and posterior urethral valve.
- Uncircumcised boys are more likely to develop UTI than circumcised boys.
- Stone in the urinary tract.
- Other causes: constipation, poor perineal hygiene, prolonged catheterization or family history of UTI.
Symptoms of Urinary Tract Infection
Older children can complain if they have problems with urination. Common symptoms of urinary tract infections are the same in older children as those in adults and are discussed in Chapter 18.
Younger children are unable to complain. Crying while voiding, difficulty or pain when voiding, foul smelling urine and frequent unexplained fever are common complaints of children with UTI. Young children with UTI may also have poor appetite, vomiting or diarrhea, poor weight gain or weight loss, irritability or no symptoms at all.
Urinary tract infection is a common cause of fever in children.