Urinary tract infections in children - it's that dangerous!
definition
A urinary tract infection is an infection (mostly by bacteria, rarely by viruses) of the urinary tract. This can lead to inflammation of the urethra. In addition, the urinary bladder can be inflamed or the ureter, which carries urine from the kidney to the bladder, can be affected by the infection. In most cases, however, it is an uncomplicated urinary tract infection of the urethra (from the urinary bladder to the exit). Typically, girls are more likely to have urinary tract infections than boys.
Read more on the subject at: Urinary tract infection
causes
Various causes can be considered for the development of a urinary tract infection. Most commonly, the urinary tract infection is caused by bacteria from the intestines. In children in particular, the urethral exit in the diaper also comes into contact with the stool. Bacteria that are eliminated from the intestine can enter the urethra and cause a urinary tract infection there.
Therefore, the most common pathogens causing urinary tract infections are enterobacteria from the intestine. These include bacterial species such as E. coli, Proteus mirabilis and Klebsiella. Enterococci and staphylococci can also cause urinary tract infections. Viruses can also be responsible for urinary tract infections, especially in children; in most cases, an infection with adenoviruses is the basis of the viral urinary tract infection.
Less common causes of urinary tract infection in children are abnormalities in the anatomy of the urinary tract. For example, guys with a narrowing of the foreskin (Phimosis) to fight. This can make hygiene in the genital area difficult. Bacteria can quickly accumulate under the foreskin - i.e. directly at the entrance to the urethra - which then trigger a urinary tract infection.
Some children are also particularly susceptible to more complicated urinary tract infections. The bacteria rise through the urethra into the bladder and from there up into the ureter. This occurs especially when reflux occurs (backflow of urine from the bladder up into the ureter). Usually this is also the result of a small misalignment of the ureter structure.
Read more on the subject at: What are the typical causes of a urinary tract infection?
diagnosis
The diagnosis of urinary tract infection is carried out in a urine sample. It is important to take the urine sample cleanly so that it is not contaminated by normal (naturally occurring) skin germs which are then mistakenly mistaken for pathogens. Various substances such as bacteria, inflammatory cells and degradation products of the bacteria can be detected in the urine sample using a U-Stix (a small piece of paper).
You can also look at the urine under a microscope and find bacteria there. A urine culture should be created in order to detect the causative germ. A few drops of urine are placed on a nutrient medium and it is then observed whether bacteria grow there.
Read more on the subject at: Urinalysis
Concomitant symptoms
A urinary tract infection in children is typically associated with what is known as dysuria. This leads to a burning sensation and pain when urinating. In addition, the urine stream can be altered by the urinary tract infection. The urine stream may increase or decrease when urinating. A change in the color of the urine can also indicate a urinary tract infection in the child. In addition, the urine can foam unusually in the toilet.
In children who can already control their bladder emptying, urinary retention can also occur.Because of the pain when urinating, the children refuse to go to the toilet, causing the urine to build up in the bladder. This can lead to uncontrolled and unwanted loss of urine. Children who are not yet able to express themselves in an understandable way are often particularly tearful and weak when they have a urinary tract infection.
In children, a urinary tract infection can also be accompanied by a fever. If there is also a bladder infection, pain in the lower abdomen (in the area of the bladder) also occurs. The infection can also migrate from the bladder to the kidneys. This manifests itself in flank pain (on the side of the back), which can occur on one or both sides. The children are very tired and tearful, they have no appetite and, despite their fever, they drink little.
Read more on the subject at: Abdominal pain in children
fever
Fever is a very unspecific symptom, especially in children. A fever can occur with every infection, as the increased temperature is a very good measure for the body to fight pathogens. In the case of urinary tract infections, too, the main purpose of the fever is to weaken the triggering bacteria. If the children have a fever, they are also very tired, limp and cry a lot, they have little appetite and do not drink much. Often they don't feel like playing and would rather lie down and sleep.
Read more on the subject at: Fever in the toddler
Pain
Pain can occur in different places depending on the severity of the urinary tract infection. At the beginning, the pain manifests itself mainly when urinating. If the urinary tract infection moves up to the bladder, the pain can also appear in the lower abdomen (where the bladder is). In the case of a complicated urinary tract infection that also affects the kidneys, flank pain can also occur. These are located at the lower end of the costal arch, on the side of the back.
Read more on the subject at: Abdominal pain in children
How contagious is a urinary tract infection in a child?
Urinary tract infections in children are usually not contagious. To be infected, the bacteria would have to get to other people from the child's urinary tract, and the person concerned would in turn have to ingest the bacteria through their mouth, for example. Since most of the pathogens causing urinary tract infections are normal intestinal germs, many people cannot be infected with these pathogens separately - they already have the bacteria in their own intestinal tract.
Read more on the subject at: How contagious is a urinary tract infection?
General treatment
The therapy of an uncomplicated urinary tract infection consists primarily of symptomatic treatment. A sufficient amount of water is important for this. This “flushes” the urinary tract, including the kidneys and the urinary bladder, and is therefore an effective method to combat bacterial infections.
If you know the reason for a fever in children, treatment of the elevated temperature is not necessarily necessary, as the fever is also useful for combating the infection. However, if the temperatures are very high (over 38.5-39 ° C) or the children suffer from their weakness (with possibly loss of appetite, headaches and no desire to drink), therapy with antipyretic drugs (paracetamol, ibuprofen) can be carried out. These drugs also have anti-inflammatory and pain-relieving effects and can thus relieve symptoms well.
Frequently, a urinary tract infection in children should also be treated with antibiotics. Antibiotics such as amoxicillin, gentamycin and ceftriaxone are used. Which antibiotic is chosen usually also depends on which causative bacterium grows in the urine culture. The antibiotic therapy can be adapted to this. In the case of urinary tract infections, which also affect the bladder and kidneys, stronger drugs tend to be used than in the case of uncomplicated urinary tract infections in children, which only affect the urethra.
Which home remedies can help?
Home remedies can mainly help relieve symptoms of urinary tract infections. There are many home remedies that can make the children drink more. While children should normally be offered water and unsweetened tea to drink, fruit juices can also be used in the event of a fever or urinary tract infection. Ideally, you mix a fruit juice with the same amount of water (sparkling or still, depending on the child's preference). Due to the sweetness in the drink, the children usually drink more than usual. The diet can also be adjusted a little so that the children absorb a lot of liquid. Soups are particularly suitable for fever and urinary tract infections to optimize the fluid balance.
Other home remedies can be used if the child has a fever. So calf compresses or a cold washcloth on the forehead can relieve the temperature a little. If the child complains of abdominal pain due to the urinary bladder inflammation, a hot water bottle is also an option. You should make the hot water bottle half full, then squeeze out the remaining air and only then screw it off. This prevents the hot water bottle from bursting if the pressure is too high.
If the children are particularly mushy and whimpering, it often helps to hold them in your arm or lap and calm them down with a story or song. Even your favorite cuddly toy can work wonders for sick children.
homeopathy
Urinary tract infections in children can be treated with homeopathic remedies in addition to antibiotic therapy. Apis is the method of choice for sharp pain. Cantharis can also be taken for painful urination. If a cold occurs in addition to the urinary tract infection, Dulcamara can be a sensible alternative. Other homeopathic remedies for urinary tract infections are, for example, Sarsaparilla, Pulsatilla and Nux vomica.
When does my child need an antibiotic?
In the case of a urinary tract infection in children, antibiotic therapy should be used in most cases. The exception are urinary tract infections that are triggered by viruses, since antibiotics are not effective here. Basically, the following rule applies to urinary tract infections: asymptomatic infections do not have to be treated with antibiotics. So if there is an incidental finding that the children have bacteria in their urine, it is not yet a cause for concern. Especially in children who still wear diapers, intestinal bacteria in the urethra area are perfectly normal. Antibiotic therapy only makes sense when symptoms such as fatigue, painful urination and fever are added.
Which antibiotics are used?
Various antibiotics are used to treat urinary tract infections in children. Amoxicillin, gentamycin and ceftriaxone are most commonly used. Depending on which pathogen is found in the urine culture, other antibiotics can also be selected. These include tobramycin, ceftriaxone and amoxicillin in combination with clavulanic acid.
Can this harm my child?
An uncomplicated urinary tract infection that occurs once does not cause any harm to children. Only when complications arise can this become a problem. For example, the infection can spread throughout the body. Antibiotic therapy is also not always cheap for children, as it can mess up the intestinal bacteria. However, in the case of a urinary tract infection, antibiotic therapy is useful in order to avoid complications. If urinary tract infections occur repeatedly, damage to the urinary tract can occur.
Complications of a urinary tract infection in a child
The complications that arise in a child with a urinary tract infection mainly occur when the pathogens spread further in the body. Urinary bladder inflammation is a frequent occurrence, which occurs much more frequently in girls than in boys due to the significantly shorter urethra. If the bacteria can rise from the bladder through the ureter to the kidney, an inflammation of the renal pelvis (Pyelonephritis) arise. Renal pelvic inflammation can also be treated well with antibiotics; if this does not succeed, however, it can lead to a generalized infection in the body up to life-threatening blood poisoning.
A single urinary tract infection is usually not a cause for concern. However, if urinary tract infections occur more frequently, especially in combination with inflammation of the renal pelvis, permanent kidney damage with functional impairments can occur. In children, inflammation of the testicles can also occur as part of a urinary tract infection.
Duration
The duration of the urinary tract infection is usually around a week. The symptoms can regress completely within this time with antibiotic therapy and possibly fever reducers. If there are additional infections of the urinary bladder or the kidneys, the duration of the urinary tract infection in the child can be significantly longer.
