Urinary infection in children: what need to be done?

uti

  Definition of urinary tract infection (UTI) is  growth of significant number of organisms of single species  in urine sample along with Symptoms. ( First aid for urinary pain in children. )

Types of UTI and common symptoms

Simple UTI: mild fever, irritable, Pain during urination, increased frequency and urgency

Complicated UTI: High grade fever, vomiting, stomache, dehydration and toxic looking child

Symptoms present less often are: heamturia, voiding issues, bed wetting , failure to thrive may also be present

 

Risk factors:    Girl child , poor hygiene, Vesicoureteral reflux (VUR), Voiding dysfunction, obstruction in urinary tract

Urine collection: mid stream clean catch sample gives most accurate report in home settings

Urine routine , microscopy s/o UTI: pus cells in urine sample, along with positive nitrate and leucocyte esterase .

Gold standard test is urine culture.. as its report takes aroung 48 hours to come, we can start antibiotics after sending urine sample for culture in consultation with doctor and wait for culture report for further plan of action.

Treatment:

Plenty of fluids, oral antibiotics and other supportive care as advised by your doctor

Plan of action as per age ( preferably in consultation with pediatric nephrologist)

  • Less than 1 years: Ultrasound, MCU and DMSA scan
  • 1-5 years of age: ultrasound and DMSA, ( if DMSA is abnormal than MCU to be done)
  • More than 5 years: Ultrasound only ( if abnormal  further work up)

In high risk cases ,we might need prophylaxis to prevent repeated episode of urinary infection.

Whenever in doubt consult pediatric nephrologists

Regards

Dr Rahul Varma

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