Does your child have Urinary Tract Infection ?

Kyra, a 5- year- old bubbly girl, loves outdoor play. She gets so busy in her play that she forgets everything else including eating, drinking and going to the toilet. That evening Kyra did not go out to play. Her mother noticed that she was dull and had fever. Her mother gave her a syrup for the fever. Fever was temporarily better but it did not settle fully and kept coming back in spite of medications. Mother took Kyra to a child specialist.

The doctor examined Kyra and asked for a urine test. He suspected that Kyra may have a urinary tract infection (UTI). Kyra’s mother had heard about urine infection in grownups but was surprised to hear that even young children can have UTI. She was very worried and had a lot of questions. What exactly is the urinary tract? What is UTI? Why do children get it? What are the symptoms? What is the treatment? Can she develop UTI again? Can UTI harm Kyra? How can it be prevented?

The good doctor patiently answered all her questions. He explained that the urinary tract consists of two kidneys that make the urine, a bag called the bladder that stores the urine and two tubes that bring the urine from each kidney to the bladder. Kidneys make urine which freely flows into the bladder. The bladder stores urine till it is full. Once it is full the bladder empties the urine out of the body. Normally, this urine is clean and does not have any germs. Sometimes harmful germs, the Bad Bacteria may enter the kidneys and bladder and cause disease. This is called UTI.

Children with UTI often have symptoms like Kyra had. High fever without any cold or cough. Sometimes, along with the fever there may be vomiting, stomach pain or backache. Some children may have pain or burning sensation when passing urine. Passing urine very frequently and wetting of the underpants can also occur.

When UTI is suspected two tests are always done. A routine urine examination and a special test called urine culture to identify the type of bad bacteria that is causing the disease. [How to collect urine for testing]

Antibiotics are needed to kill the bacteria and treat the UTI. These can be usually taken orally. Sometimes, if the child is very small or the infection is very severe injectable antibiotics are needed. Antibiotics are given for 7 to 10 days. In most children with UTI an ultrasound of the kidneys (sonography) is usually done to check if there is any defect in the kidneys.

Some children will need additional tests. One of these is a special Xray called MCU. This test is usually done if the UTI occurs in children less than 2 years of age, if the child has had more than one UTI or if a boy gets UTI.UTIs can harm the kidneys and leave behind scars especially if infections occur repeatedly. Scarred kidneys may lead to high blood pressure and poor kidney function in later life. Scars can be detected by a special kidney scan called a DMSA scan which may be done 3 to 6 months after the UTI has settled.

Preventing a second attack of UTI s important to avoid harm to the kidney. Drinking plenty of water, going regularly to the bathroom to pass urine (once in 2 to 3 hours), not holding back the urine will help to prevent a second attack of UTI. Some children may require a small dose of an antibiotic at night for several months or longer to prevent infections.Preventing and treating constipation is very important to prevent the growth of bad bacteria in the body. Plenty of water, vegetables and fruits will prevent constipation. Avoiding refined flour (maida) and bakery products such as bread biscuits, cakes and fried foods will help to prevent constipation.