What Is a Urinary Tract Infection?
A urinary tract infection (UTI) is an infection of the urinary tract caused by bacteria. A lower UTI affecting the bladder and an upper UTI involving the kidneys (pyelonephritis) can vary in severity. UTIs are common in children, and recognizing them promptly is important.
Signs
Symptoms vary by age. In infants, there often isn't a typical urinary complaint; instead, unexplained fever, fussiness, reduced feeding, vomiting, or poor weight gain may be seen. In older children, burning with urination, frequent urination, abdominal or flank pain, urinary incontinence, and a change in the smell or color of the urine can occur. A higher fever raises the possibility that the kidneys are also involved.
When to See a Physician
Prompt medical attention is recommended for unexplained fever, especially in infants; for urinary complaints accompanied by fever in older children; for recurrent infections; and for any general decline in the child's condition. Because a UTI in children can be the first sign of an underlying urinary tract difference, it should be taken seriously.
Diagnosis
Diagnosis is made with a urinalysis and urine culture; the culture helps identify the causative bacteria and guide appropriate treatment. For recurrent or febrile infections, the physician may recommend an ultrasound and, if needed, additional studies (such as a voiding cystourethrogram/VCUG or DMSA scan) to evaluate the kidneys and urinary tract. These tests are done in particular to look for conditions like vesicoureteral reflux (urine backing up from the bladder toward the kidney).
Treatment
Treatment is generally with appropriate antibiotics, which should be completed fully for the duration and dose the physician prescribes. Adequate fluid intake, preventing constipation, and good toilet habits support treatment. If an underlying condition is identified (such as reflux), it's addressed separately.
Prevention
Adequate fluid intake, regular toilet habits, preventing constipation, and proper hygiene (wiping front to back in girls) can help reduce the risk of recurrent infection.
Frequently Asked Questions
Can a UTI damage the kidneys?
Most infections treated promptly heal without issue; recurrent, febrile infections can pose a risk to the kidneys, so follow-up is important.
Should every fever be considered a possible UTI?
Unexplained fever, especially in infants, should raise suspicion of a UTI; the decision rests with the physician.
What should be done if it keeps recurring?
An underlying cause should be investigated.