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CHILDHOOD URINARY TRACT INFECTIONS – CYSTITIS IN CHILDREN

What are Childhood Urinary Tract Infections ?

We each have two kidneys, one on each side. The kidneys are connected to the bladder by two tubes, called ureters. The kidneys filter the blood and pass waste products in the urine to the bladder. The bladder stores the urine until it is passed out of the body. If bacteria get into the urine, they can cause a urinary tract infection. The child may need to pass urine very often, or have pain when they pass urine. Small children may not have these symptoms and may just be unwell with a fever, tummy ache or vomiting. A urine test is needed to show that there is an infection.

How do Childhood Urinary Tract Infections occur ?

Bacteria can get into the urine from the skin or the bowel. A few children have a problem which means they are more likely to get a urinary tract infection. In some children urine is pushed in the wrong direction when they pass urine, towards the kidneys. This is called reflux, and can carry an infection up to the kidneys from lower parts of the urinary tract. If the passage of urine out of the kidneys is blocked, an infection is also more likely. Constipation and not emptying the bladder properly also can make infection more likely.

Why do Childhood Urinary Tract Infections occur ?

We do not know why it happens. Most children who have urinary tract infections have normal kidneys, ureters and bladder. Problems like reflux can start when the kidneys are developing before birth.

Treatment Involved for Childhood Urinary Tract Infections

A urine sample will be needed to confirm the type of bacteria causing the infection. The doctor will prescribe a course of antibiotics. It is important to finish the course and not just stop when the symptoms go. Give the child plenty to drink and make sure that urine is passed regularly. Give paracetemol if the child has a fever. Urinary tract infections are common and in most cases do not cause any damage to the kidneys. A few children are left with a small scar on the kidney which will not affect its function. A very small number of children have many urine infections and scars on their kidneys which can damage the function of the kidneys. This is more likely if the child is very young (under 1 year). Further tests may be arranged to check if there is a scar or if there is a problem which makes infections more likely. More tests will be done for younger children.

There are several different kinds of test: Ultrasound This is used most often because it is simple and does not hurt. A scanner is passed over the abdomen to show the shape of the kidneys and bladder. Isotope scan This can look for scars and may show how urine is draining from the kidneys. A small injection of a radioactive marker is injected into a vein, and then a scanner forms a picture of the kidney by measuring the radioactivity. The amount of radioactivity is safe and less than used in an ordinary X ray. Micturating cysto urethrogram (MCU) This test will look for reflux and any hold up in the passage of urine. A catheter (a thin plastic tube) is passed into the bladder through the opening. The bladder is filled through the catheter and X rays are taken while the child passes urine. Treatment depends on the results of the scans. Children may be given a small daily dose of antibiotic to protect them from infections. The scans may need to be repeated when the child is older.

During Treatment for Childhood Urinary Tract Infections

Occasionally antibiotics can cause an allergic rash and the doctor should be contacted.

After Treatment for Childhood Urinary Tract Infections

Your doctor may arrange a urine sample to check that the infection has been cleared. If the child has the same symptoms again or has a temperature without an obvious cause it is important to check a urine sample.

If Childhood Urinary Tract Infections are Left Untreated

Urine infections are quite common and most children do not have any problems afterwards. A very small number of children develop damage to their kidneys which may lead to high blood pressure or kidney problems as adults. The investigations are to find these children and prevent this happening.

Effects on Family of Childhood Urinary Tract Infections

The tests involved can be distressing for the child and their family. The doctors will be happy to explain what will happen. It is helpful to explain what will happen to your child even if they are very young. The hospital may be able to help you prepare your child for the tests they need.