$Unique_ID{PAR00175}
$Pretitle{}
$Title{Medical Advice:  Urinary Tract Infections}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Urinary Tract Infections Frequent urgent painful urination Dribbling
urine sample Bed-wetting Fever Abdominal back pain diarrhea urinate urinates
urinating vomit Vomiting genital Redness genitals infection pyelonephritis
pyelitis kidney kidneys cystitis urethritis UTI Escherichia coli bacteria
bacterium bacterial vagina bladder urethra constipated constipation
incontinence antibiotic antibiotics}
$Log{}

Your Child:  A Medical Guide


Urinary Tract Infections


     Quick Reference

     SYMPTOMS
     - Frequent, urgent, or painful urination
     - Dribbling of urine
     - Bed-wetting
     - Inability to control urination
     - Abnormal urine
     - Fever
     - Abdominal or back pain
     - Chronic diarrhea
     - Vomiting
     - Redness of external genitals

     HOME CARE
     - Do not attempt home treatment.  If symptoms are present, the child
       should be seen by a doctor.

     PRECAUTIONS
     - Attempted home treatment can cause a low-grade, chronic infection.
     - In many cases, there will be a fever but no other symptoms, and the
       infection will not be evident in the course of a physical examination.
     - A urine sample should be collected at the midpoint of urination.
     - An infant in whom such an infection is suspected should be examined as
       soon as possible to find the underlying cause.


     The urinary tract is a series of connecting structures, and an infection
in one part easily spreads to another.  For this reason, it is difficult to
distinguish among pyelonephritis and pyelitis (infection of the collecting
basins of the kidneys), cystitis (infection of the bladder), and urethritis
(infection of the tube that leads from the urinary bladder to the outside of
the body).
     In many cases, except during infancy, there is no physical abnormality to
account for the development of a urinary tract infection (UTI).  However, in 5
percent of girls and over 50 percent of boys with a UTI, it is due to an
underlying anatomical abnormality somewhere along the urinary tract that
results in a partial or total block in the flow of urine.
     Most UTIs are caused by organisms that do not cause disease in other
locations in the body.  For example, Escherichia coli bacteria live harmlessly
in the bowels of all children and adults but cause infection when they enter
the urinary tract.  Other causes of UTI are inflammation of the vagina,
foreign bodies in the bladder or urethra, and possibly severe constipation.
     Beyond infancy, UTIs occur ten times more frequently in girls than in
boys.  About 5 percent of all girls will have one or more UTIs before reaching
maturity.

SIGNS AND SYMPTOMS

     A UTI may produce either no symptoms at all (silent UTI) or any
combination of the following symptoms:  urgency or frequency of urination,
painful urination, dribbling of urine, bed-wetting, daytime incontinence
(inability to control urination), fever, abdominal or back pain, vomiting,
chronic diarrhea, redness of the external genitals, or foul-smelling, cloudy,
or bloody urine.  If the infection is untreated, the symptoms often disappear
in a few days or weeks, but are likely to return later.
     The diagnosis of UTI depends on the findings from a careful physical
examination and urine tests.  In boys, the diagnosis involves a search for an
obstruction in the urinary tract.  In girls, the search for an obstruction
usually is undertaken only after two or three bouts of UTI or one bout with a
UTI that is resistant to treatment.  In an infant, whether a boy or a girl,
investigation for the underlying cause should always be undertaken
immediately.

HOME CARE

     Any attempt at home treatment is potentially dangerous and may result in
a low-grade, destructive infection with no outward symptoms.  The child should
be seen by a doctor.

PRECAUTIONS

  -  A UTI, particularly one of a series of infections, commonly produces
     fever but few or no other symptoms.  The doctor's physical examination
     may reveal nothing unusual.
  -  To obtain an uncontaminated urine specimen for analysis or culture,
     cleanse the genitals and collect the sample at the midpoint of urination.

MEDICAL TREATMENT

     Your doctor will perform a complete physical examination, including
taking your child's blood pressure, and will order urine tests.  If the urine
specimen shows an infection, the doctor will prescribe antibiotics for ten to
14 days.  Urine samples will be retested during and after the course of
antibiotics.
     After your child has recovered from a UTI, the doctor may recommend an
x-ray examination to determine if there is a physical abnormality.  Sometimes,
further x-ray studies and direct examination of the urethra and bladder are
necessary.  To treat recurrent UTIs that are not due to obstruction, your
doctor may prescribe the use of antibiotics continuously or on and off for
months or years.  Surgery may be necessary to correct an obstruction.

RELATED TOPICS:  Bed-wetting; Constipation; Diarrhea in older children;
Diarrhea in young children; Fever; Nephritis; Stomachache, chronic; Vaginal
discharge; Vomiting