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Urinary tract infection - children

UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children

A urinary tract infection is a bacterial infection of the urinary tract. This article discusses urinary tract infections in children.

The infection can affect different parts of the urinary tract, including the bladder (cystitis), kidneys (pyelonephritis), and urethra, the tube that empties urine from the bladder to the outside.

Images

Female urinary tract
Male urinary tract
Voiding cystourethrogram
Vesicoureteral reflux

Causes

Urinary tract infections (UTIs) can occur when bacteria get into the bladder or to the kidneys. These bacteria are common on the skin around the anus. They can also be present near the vagina.

Some factors make it easier for bacteria to enter or stay in the urinary tract, such as:

UTIs are more common in girls. This may occur as children begin toilet training around 3 years of age. Boys who are not circumcised have a slightly higher risk of UTIs before age 1.

Symptoms

Young children with UTIs may have a fever, poor appetite, vomiting, or no symptoms at all.

Most UTIs in children only involve the bladder. It may spread to the kidneys.

Symptoms of a bladder infection in children include:

Signs that the infection may have spread to the kidneys include:

Exams and Tests

A urine sample is needed to diagnose a UTI in a child. The sample is examined under a microscope and sent to a lab for a urine culture.

It may be hard to get a urine sample in a child who is not toilet trained. The test cannot be done using a wet diaper.

Ways to collect a urine sample in a very young child include:

Imaging may be done to check for any anatomical abnormalities or to check kidney function, including:

Your health care provider will consider many things when deciding if and when a special study is needed, including:

Treatment

In children, UTIs should be treated quickly with antibiotics to protect the kidneys. Any child under 6 months old or who has other complications should see a specialist right away.

Younger infants will most often need to stay in the hospital and be given antibiotics through a vein. Older infants and children are treated with antibiotics by mouth. If this is not possible, they may need to get treated in the hospital.

Your child should drink plenty of fluids when being treated for a UTI.

Some children may be treated with antibiotics for periods as long as 6 months to 2 years. This treatment is more likely when the child has had repeat infections or vesicoureteral reflux.

After antibiotics are finished, your child's provider may ask you to bring your child back to do another urine test. This may be needed to make sure that bacteria are no longer in the bladder.

Outlook (Prognosis)

Most children are cured with proper treatment. Most of the time, repeat infections can be prevented.

Repeated infections that involve the kidneys can lead to long-term damage to the kidneys.

When to Contact a Medical Professional

Call your provider if your child's symptoms continue after treatment, or come back more than twice in 6 months or your child have:

Prevention

Things you can do to prevent UTIs include:

To prevent recurrent UTIs, the provider may recommend low-dose antibiotics after the first symptoms have gone away.

Related Information

Urinary tract infection - adults
Enlarged prostate
Urethral stricture
Bowel incontinence

References

American Academy of Pediatrics. Subcommittee on urinary tract infection. Reaffirmation of AAP clinical practice guideline: the diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months of age. Pediatrics. 2016;138(6):e20163026. PMID: 27940735 pubmed.ncbi.nlm.nih.gov/27940735/.

Jerardi KE and Jackson EC. Urinary tract infections. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 553.

Sobel JD, Brown P. Urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 72.

Wald ER. Urinary tract infections in infants and children. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2020. Philadelphia, PA: Elsevier; 2020:1252-1253.

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Review Date: 1/1/2020  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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