A urinary tract infection (UTI) is an infection of the urinary tract. This article discusses UTIs in children.
The infection can affect different parts of the urinary tract, including the:
Urinary tract infections (UTIs) can occur when bacteria get into the bladder or the kidneys. These bacteria are common on the skin around the anus. They can also be present near the vagina.
Normally, there are no bacteria in the urinary tract. However, some things make it easier for bacteria to enter or stay in the urinary tract. These include:
UTIs are more common in girls. They may occur often around age 3, as children begin toilet training. Boys who are not circumcised have a slightly higher risk of UTIs before age 1.
Young children with UTIs may have a fever, poor appetite, vomiting, or no symptoms at all.
Most urinary tract infections in children only involve the bladder. If the infection spreads to the kidneys (called pyelonephritis), it may be more serious.
Symptoms of a bladder infection in children include:
Signs that the infection may have spread to the kidneys include:
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:
If this is your child's first UTI, imaging tests may be done to find the cause of the infection or check for kidney damage. Tests may include:
These studies may be done while the child has an infection. Most often, they are done weeks to several months later.
Your health care provider will consider many things when deciding if and when a special study is needed, including:
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 urinary tract infection.
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 health care 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.
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.
Call your health care provider if your child's UTI symptoms continue after treatment, or come back more than twice in 6 months.
Call your health care provider if the child's symptoms get worse. Also call if your child develops new symptoms, such as:
Things you can do to prevent UTIs include:
To prevent recurrent UTIs, the health care provider may recommend low-dose antibiotics after the first symptoms have gone away.
UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children
Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, Behrman RE. Urinary tract infections. In: Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 169.
Skoog SJ, Peters CA, Arant BS Jr, et al. Pediatric Vesicoureteral Reflux Guidelines Panel summary report: clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates/infants with prenatal hydronephrosis. J Urol. 2010;184:1145-1151.
White B. Diagnosis and treatment of urinary tract infection in children. Am Fam Physician. 2011;83:409-415.
Williams G, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev. 2011;(3):CD001534.
Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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