Q1. How common is urinary tract infection (UTI)? In whom does it occur?
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Q2. Why is it important to diagnose and manage urinary tract infection?
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Q3. How does urinary tract infection occur?
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Q4. How can urinary tract infection be detected?
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Q5. Why is the early detection of urinary tract abnormalities and prevention of renal infection important?
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| Q1. |
How common is urinary tract infection (UTI)? In whom does it occur? |
| A1. |
Urinary tract infection is quite common in children. Surprisingly, it is as commonly, not diagnosed.
Infection of the urinary tract occurs both in normal children and in those with some urinary tract abnormality. |
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| Q2. |
Why is it important to diagnose and manage urinary tract infection? |
| A2. |
The reason why so much of importance is placed upon the diagnosis and management of this problem is because, firstly, unlike other diseases, infants who have urinary tract infection may not have any symptoms pertaining to the urinary tract at all.
The common belief that most parents have is that an infant with urinary tract infection should have symptoms such as a burning sensation while urinating, blood in the urine, difficulty in passing urine and so on.
This belief is incorrect. Infants who are less than one year of age and have urinary tract infection may only not feed well and may have fever, loose stools, vomiting, etc. Unless one has a high degree of suspicion about the presence of a urinary tract infection, it can be missed.
The second reason is that, if urinary tract infection is missed, it can cause disastrous results. If the kidneys are affected because of urinary tract infection, it can result in irreversible damage and have terrible long-term consequences. These are renal scarring, blood pressure, protein in the urine, or ultimately chronic renal failure.
When these have set in, no matter what is done at a later stage, the problems cannot be set right. |
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| Q3. |
How does urinary tract infection occur? top |
| A3. |
Infection commonly occurs as a result of bacteria ascending from the genital area. Girls have a higher incidence of this in their early years because of their short urethra.
There may be numerous other causes contributing to the incidence of urinary tract infection. The causes may be that the urine flowing down from the kidney may be blocked at different levels, or that the normal flow of urine out of the bladder is disturbed, with urine flowing backwards into the kidney.
Kidney scarring, the most serious long-term result, occurs due to the urine flowing backwards into the kidney, or because pressure in the kidney is increased by the block and there is added infection.
Those who have had infection very early in their life and who have had severe scars in the kidneys are more prone to hypertension and nephropathy. |
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| Q4. |
How can urinary tract infection be detected? |
| A4. |
Children who have a fever of an unknown cause must have a urine test performed. It hardly costs Rs. 15, even in a private clinic, and will provide a very good indication if urinary tract infection is present.
Once urinary tract infection has been detected, children under the age of 5 years must undergo further tests such a urine culture, an ultrasound evaluation or an x-ray. These are required to find out the degree and cause of the infection, and to decide on the treatment required.
All boys above the age of 5 years and those girls with recurrent infection or infection with high fever will undergo a similar evaluation. |
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| Q5. |
Why is the early detection of urinary tract abnormalities and prevention of renal infection important? |
| A5. |
The goal of current practice is the early detection of urinary tract abnormalities and the prevention of renal infection by either medical or surgical means.
Long-term studies have shown a 10% incidence of renal failure, a 13% incidence of blood pressure, and another 13% incidence of toxemia during pregnancy.
When one considers that renal scarring is the fourth leading cause for renal transplantation in children, the need for prevention becomes obvious. |
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