Urinary Tract Infections
Most UTIs are bacterial infections of the mucosal surface of the urinary tract.
- The infection may occur anywhere from the urethra to the renal parenchyma.
- A temperature greater than 38.5 °C may help to differentiate acute pyelonephritis from lower tract UTIs.
- The most common organism causing UTI in children is Escherichia coli, accounting for up to 70% of infections.
- Other bacterial pathogens include Pseudomonas aeruginosa (nonenteric Gram-negative), Enterococcus faecalis, Klebsiella pneumoniae, group B Streptococcus (predominantly in neonates).
UTI may involve the kidneys (pyelonephritis), when it is usually associated with fever and systemic involvement, or may be due to cystitis, when there may be no fever. UTI in childhood is important because:
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Up to half of patients have a structural abnormality of their urinary tract.
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Pyelonephritis may damage the growing kidney by forming a scar, predisposing to hypertension and to progressive chronic kidney disease if the scarring is bilateral.
Infants
- Fever
- Vomiting
- Lethargy or irritability
- Poor feeding/faltering growth
- Jaundice
- Septicaemia
- Offensive urine
- Febrile seizure (>6 months)
Children
- Dysuria, frequency and urgency
- Abdominal pain or loin tenderness
- Fever with or without rigors (exaggerated shivering)
- Lethargy and anorexia
- Vomiting, diarrhoea
- Haematuria
- Offensive/cloudy urine
- Febrile seizure
- Recurrence of enuresis
A urine sample should be tested in all infants with an unexplained fever >38° C
UTI is the Most Common Cause of Hematuria
Urinary Tract Infection
- Bacteria
