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Pediatric Urinary Tract Infection (UTI)
Key Points About a UTI in Children
- A urinary tract infection (UTI) is inflammation of part of the system that takes urine out of the body.
- Most infections are caused by bacteria from the digestive tract. The most common is E. coli bacteria. These normally live in the colon.
- A UTI is not common in children younger than age 5. A UTI is much more common in girls because they have a shorter urethra.
- A UTI is unlikely in boys of any age, unless part of the urinary tract is blocked. Uncircumcised boys are more at risk for a UTI than circumcised boys.
- Symptoms vary by age. They can include fever, need to urinate often, pain and crying.
A urinary tract infection is inflammation of part of the system that takes urine out of the body. It’s caused by bacteria. The urinary tract includes the two kidneys. They remove liquid waste from the blood in the form of urine. Narrow tubes (ureters) carry urine from the kidneys to the bladder. Urine is stored in the bladder. When the bladder is emptied, the urine travels through a tube called the urethra and passes out of the body. Bacteria can infect any part of this system.
Normal urine contains water, salts and waste products. It's free of germs such as bacteria, viruses and fungi. An infection happens when germs enter the urethra, travel up to the bladder, ureters and kidneys, and begin to grow. Most infections are caused by bacteria from the digestive tract. The most common is E. coli (Escherichia coli) bacteria. These normally live in the colon.
A UTI is not common in children younger than age 5. A UTI is much more common in girls. This is because they have a shorter urethra. A UTI is unlikely in boys of any age. But it can occur in boys if part of the urinary tract is blocked. Uncircumcised boys are more at risk for a UTI than circumcised boys. A child with a part or full blockage in the urinary tract is more likely to develop a UTI.
Bubble baths may irritate the urethra and allow bacteria to grow there. Incorrect wiping (child should wipe front to back) increases the risk. This is even more risky after a bowel movement. Delaying going to the bathroom and constipation are also linked to UTIs.
Symptoms can be a bit different for each child.
Symptoms in babies can include:
- Bad-smelling urine
- Poor feeding
Symptoms in children can include:
- Sudden need to urinate
- Need to urinate often
- Loss of control of urine (incontinence)
- Pain while urinating
- Trouble urinating
- Pain above the pubic bone
- Blood in the urine
- Bad-smelling urine
- Nausea and vomiting
- Pain in the back or side below the ribs
The symptoms of a UTI can seem like other health conditions. Have your child see their health care provider for a diagnosis.
The health care provider will ask about your child’s symptoms and health history. The provider will give your child a physical exam. Your child may also have tests, such as:
- Urine testing (urinalysis). Your child’s urine is sent to a lab to check for red blood cells, white blood cells, bacteria, protein and signs of infection. The urine will also be sent for a culture and sensitivity. This is done to figure out what type of bacteria is causing the infection and what medicine is best to treat the infection.
- Kidney ultrasound. This is a painless imaging test. It uses sound waves and a computer to make images of blood vessels, tissues and organs. It can show internal organs as they function and can assess blood flow through vessels. A boy with a UTI or a girl younger than age 5 or 6 may need this test.
- Voiding cystourethrogram (VCUG). This is a type of X-ray of the urinary tract. A thin, flexible tube (catheter) is put in the tube that drains urine from the bladder to the outside of the body (the urethra). The bladder is filled with a liquid dye. X-ray images are taken as the bladder fills and empties. The images will show if there is any reverse flow of urine into the ureters and kidneys.
- Nuclear medicine scan. This scan can help find out if there is scarring or a more severe infection. A small amount of radioactive tracer is injected through an IV. Then pictures of the kidneys will be taken. This will show how well the kidneys are working.
Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is. Treatment may include:
- Taking antibiotic medicine
- Using a heating pad or medicines to ease pain
- Drinking plenty of water
Your child's health care provider may want to see them back again a few days after treatment starts to see how treatment is working.
Talk with your child’s health care providers about the risks, benefits and possible side effects of all treatments.
You can help prevent UTIs in your child if you:
- Have your child drink plenty of fluids
- Tell your child to empty their bladder fully when urinating
- Teach girls to wipe from the front to back after going to the bathroom
- Make sure your child doesn’t get constipated
Call the health care provider if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
Learn about treatment
Urology Treatment at Children's National Hospital
The Division of Urology at Children's National Hospital offers expert care and advanced diagnostic testing in a family-centered environment. Discover more about the treatment we offer.
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We are dedicated to helping children overcome challenges with wetting problems and urinary tract infections in our WISH Clinic (Wetting, Infections, and Stooling Help).
At Children’s National Hospital in Washington, D.C., our pediatric urologists provide comprehensive care for disorders affecting reproductive and urinary organs.