Urinary tract infection is very common in childhood. It affects approximately 1 in 100 boys, and is more common in them, during the first year of life. In girls, urinary tract infection occurs more commonly around potty training age.
How is it Diagnosed?
The symptoms of urinary tract infection may be particularly non-specific in young children and may comprise merely of a high fever, loss of appetite, nausea, vomiting, and diarrhoea. If chronic, a general failure to thrive can be an additional symptom. It is important that the possibility of urinary tract infection is suspected, and a urine test be performed when children with these sorts of symptoms are seen. In older children, more specific complaints may occur, to include burning on passing urine, blood in the urine, mild fever, and lower abdominal or back pain.
How is it Diagnosed?
Urinary tract infection is diagnosed by testing the urine in the laboratory to grow the infection-causing bacteria, and assessing the urine with a microscope. There are various quick dip tests performed principally in GP Surgeries, though these are not completely reliable, and often fail to identify the bacteria causing the infection. Although such investigations are very helpful in making a quick diagnosis, it is extremely important that the laboratory investigation is also performed.
What is the Treatment?
The first line treatment for urinary tract infection is antibiotics. These are usually very affective, though in a severe case affecting a very ill child with a high fever, antibiotics may need to be given in hospital intravenously, alongside intravenous fluid, which helps the child much more quickly. It is particularly important to check that the correct antibiotic is used, by cross-referencing with the laboratory culture results after 1 or 2 days.
The second line of management is to investigate the child for underlying urinary abnormalities, and these may be seen in up to 40% of patients. There are well-recognised protocols of investigation with ultrasound and other scans, which help rationalise the situation and determine whether further treatment – such as surgery – may be required.