The urinary tract is the system of organs that makes, stores, and carries urine out of the body. The organs in the urinary tract include the kidneys that make urine, the ureters which are the thin tubes that carry urine from the kidneys to the bladder, the bladder that stores urine and the urethra is the tube that carries urine out of the body. A urinary tract infection (or “UTI”) is usually caused by bacteria. Normally, bacteria are not in the urinary tract. But if they travel up the urethra and get into the bladder or kidneys, they can cause a UTI. Kidney infections are the most serious type of UTI because, if not treated quickly, the infection can permanently damage the kidneys. Damage to the kidney can lead to high blood pressure and kidney failure later in life. Some children have a higher chance of developing a UTI. Children can have a higher chance of getting a UTI if their urinary system didn’t form normally before birth, their bladder doesn’t work normally or are using a urinary catheter. Having an episode of UTI increases the chance of getting another UTI. Boys who are not circumcised are at a bigger risk of getting a urinary tract infection. There is a four to ten times higher risk of UTIs in uncircumcised boys, although most uncircumcised boys do not develop UTIs. Symptoms of a urinary tract infection depend largely on a child’s age. Children younger than two years old can have one or more of fever (this might be a child’s only symptom), vomiting or diarrhea, acting fussy or not feeding well. Children aged two years and older can have pain or a burning feeling when they urinate, need to urinate more often than usual, pain in the lower belly or on the sides of the back, or fever. If your child develops the above symptoms suspicious of a urinary tract infection, immediately seek medical attention as delayed intervention may lead to more serious fatal or long standing health impact on the child such as kidney failure. A urine sample is usually needed to determine if the child has a UTI. For young children who are not toilet trained, it is usually necessary to insert a thin sterile tube (a catheter) into the bladder to obtain a urine sample. This urine sample is then taken for laboratory testing to look for features of infection. Imaging tests, such as ultrasound or x-ray, can show if a child’s urinary system did not form correctly before birth. Imaging tests are generally done in younger children (less than three to five years old) or in children who have had more than one UTI. Antibiotics are used to treat urinary tract infections (UTI). The best antibiotic depends on the child’s age, the germ that caused the UTI, and the resistance that germs have. Most children who are older than two months are given an antibiotic by mouth, in a liquid or chewable tablet. If the child is less than two months old, or if the child is vomiting and unable to take medicine by mouth, it may be necessary for the child to be admitted to the hospital for treatment with antibiotics given through the vein. Antibiotics are usually prescribed for a total of five to ten days. In all cases, it is important for the child to take each dose of the antibiotic on time and finish all of the medicine. The child usually begins to feel better within 24 to 48 hours of starting antibiotics. If the child does not get better or worsens, he or she should be seen again, by a doctor. Most children who have a UTI have no long-term damage to the urinary tract from the infection. It is not necessary to have another urine test after a child has finished antibiotic treatment, as long as the UTI symptoms have resolved. The writer is Resident in Surgery, Rwanda Military Hospital, iangashugi@gmail.com
