Posted by Dr Joe on July 15, 2019 · Leave a Comment
Urinary tract infection (bladder, Kidneys) is a very common issue in children and sometimes not the easiest to diagnose. The symptoms depend on the age and sex of the child, and the location of the infection and these symptoms can vary across the board. Urinary tract infections (UTI) are more common in females as a rule but during the first year of life, when it is most difficult to diagnose, the incidence is just about the same in males and females.
Sometimes there is an anatomical problem with abnormalities in the kidney or bladder or both that children can be born with, but most of the time these infections occur de novo. An infection is defined as bacterial growth in the urine in the presence of appropriate symptoms. If there are no symptoms, the presence of bacteria might only mean colonization, eg: there are bacteria in the urine but have not caused a body reaction yet. Under certain circumstances even colonization needs to be treated.
During the first year of life, one might only see a very irritable, cranky baby with or without fever and the source of those symptoms is “hidden” sometimes even to the best and most experienced physician. Therefore, during the first year of life the suspicion for a UTI is very high and the urine might be checked more often than it would in an older child with the same symptoms. As you can imagine, obtaining a “clean” urine specimen is very difficult so a variety of methods have been devised. If one merely “catches” the urine as it is produced externally this stands a significant chance of being contaminated by bacteria living on the skin. The best ways of obtaining a reliable urine specimen is somewhat invasive but at least your doctor can rely on the results of the evaluation. These consist of either a bladder catheterization, where a small tube is passed up into the bladder and a urine specimen is obtained or a supra pubic needle aspiration where a needle on a syringe is passed through the lower abdominal wall and a urine sample is obtained. The urine sample is obtained by a reliable lab or sometimes in the Doctor’s office by means of a urinalysis and a culture of the urine to be sure there are bacteria in it and what kind it may be so as to choose the correct treatment. This culture can take 2- 3 days to complete.
This is a very large and important subject so I will stop here and take on the topic of treatment of UTIs and possible further diagnostic procedures in my next entry.
