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UTI is common in infants and children, and, if untreated, it can cause irreversible chronic renal failure.
Epidemiology
One to 2% of newborn girls and boys have UTIs. In infancy and childhood, UTI is more common in girls than in boys; 1% of school-age girls develop symptomatic infection each year. This incidence increases even further when adolescent girls become sexually active.
Risk factors for UTI in females include sexual intercourse, sexual abuse, useof bubble bath, constipation, cystitis, urine infection pinworms, and infrequent or incomplete voiding. In either sex, risk factors include ureteric reflux in a sibling, urologic abnormalities, indwelling urethral catheterization, and orinaria
Pathophysiology
UTI usually is caused by bacteria that ascend up the urethra into the bladder. Escherichia coli is by far the most common organism associated with
Other enteric bacteria include Klebsiella, Enterococcus sp, and Staphylococcus saprophyticus (a common cause in males which can also occur in females).
Clinical Evaluation
In prepubertal children, UTI usually does not cause frequency, dysuria, or urgency. In children, symptoms of urethral irritation are more likely to be caused by bubble bath irritation, vaginitis, pinworms, masturbation, or sexual abuse.
In the newborn, signs of UTI may include late-onset jaundice, hypothermia, signs of sepsis, failure to thrive, vomiting, and fever. In infants and preschool children, additional findings include diarrhea and strong-smelling urine.
The school-age child may complain of frequency, dysuria, and urgency, but enuresis, strong-smelling urine, and vomiting also are
| Signs and Symptoms of UTI In Children |
Newborns |