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YOUR CHILD’S HEALTH CARE/ GENITAL, GROIN AND URINARY TRACT PROBLEMS: URINARY TRACT INFECTION (UTI)

Infections of the urinary tract are common in children, especially amongst girls. Cause

Urinary tract infections are caused by germs which infect the urethra (the urinary opening) and sometimes the bladder. Infections are more common where there are abnormalities of the kidneys or urinary tract (such as vesico-ureteric reflux — see p. 278) where the urine collects, thereby encouraging the growth of germs.

Clinical features

Older children usually complain of classic symptoms such as pain or stinging on passing urine, or a frequent urge to run to the toilet. Sometimes they pass small amounts of urine often and have difficulty in getting started. These symptoms can be accompanied by fever, abdominal pain and blood may be present in the urine. The younger the child the less specific are the symptoms; he may have an unexplained fever, irritability and bouts of crying, go off his feeds and even vomit.

Investigations

It is impossible to diagnose a UTI on symptoms alone. It is always necessary to back up any suspicions with a urine test, performed before the child has started taking antibiotics prescribed by the doctor. Once a course of antibiotics has commenced, it is impossible to identify the germ in the urine, and this makes treatment more difficult.

If there is a chance that the cause of your child’s UTI is an underlying structural abnormality of the kidneys or urinary tract, such as vesico-ureteric reflux, then further investigations such as a micturating cystourethrogram, or a renal ultrasound may be recommended by your doctor and your child may be referred to a paediatric specialist. Most children who have a urinary tract infection need to have these tests to make sure there is no underlying abnormality.

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