Urinary tract infections are the most common health problem in childhood after upper respiratory tract infections. These complaints, which can be frequently encountered in both genders..
And in children of all ages, can occur if they are not identified in time and the necessary treatment is not given; It can cause many permanent damages, from kidney failure to hypertension, anemia to growth retardation. In pediatric patients with recurrent urinary tract infections, further investigation is necessary and they should be evaluated by pediatric nephrologists.
What is Urinary Tract Infection?
Urinary tract infection affects the kidneys and It is inflammation of the bladder. Inflammation of the bladder is called "cystitis" and inflammation of the kidneys is called "pyelonephritis". Although pyelonephritis is less common than cystitis, it is more damaging. It often occurs when bacteria from the skin outside the urethra (the channel through which urine is expelled) reach the bladder. Treating urinary tract inflammation is important to protect the kidneys.
What is the Frequency of Urinary System Infections?
Urinary system infections are detected in 2 percent of children with fever under the age of 5. In children with fever under 1 year of age, the cause of fever in 8 percent of girls and 3 percent of boys is urinary system infections.
What are the Causes of Urinary System Infections?
The causative agent of urinary tract infections is bacteria. The bacteria enters the bladder through the tube through which urine is expelled. Factors that generally irritate the entrance of the urethra (known irritants are bath foams and shampoos) also facilitate the entry of bacteria from here.
Some risk factors predispose to urinary tract infection in children. Abnormal flow of urine from the bladder along the ureters to the kidney Al reflux, urinary system obstructions, various anatomical and functional disorders and susceptibility to infection may be observed. Foreign objects, catheters placed in the bladder, ureters, constipation, bath bubbles, and phimosis in uncircumcised boys (failure of the foreskin to fold back) cause the bladder to come into contact with bacteria. The act of hiding urine at home, which is common in school children, is also one of the causes of urinary tract infections.
What are the symptoms of urinary tract infections in children?
Symptoms and signs of urinary tract infections in children. It varies depending on age. In infants and especially children under 2 years of age, symptoms are usually not related to the urinary system and can be easily overlooked.
The most common symptoms in infants and children under 2 years of age are:
• Restlessness
• Vomiting and diarrhea
• Abdominal bloating
• Prolonged jaundice in the newborn
• Loss of appetite and malnutrition
• Slow weight gain
• Body temperature irregularity
• Fever that rises and does not fall for no reason
Symptoms are more pronounced in older children and adults and findings vary depending on the location of the infection.
Lower urinary tract (cystitis) Symptoms seen in infections are as follows:
• Burning, aching pain while urinating
• Frequent urination
• Urgent desire to urinate
• Pain in the lower abdomen
/> • Urinary incontinence before reaching the toilet
• Foul-smelling, abnormally colored, bloody urine
Acute pyelonephritis, one of the upper urinary tract infections, is the most severe urinary tract infection and the disease that causes the most damage to the kidneys. The possibility of permanent damage is higher, especially in young children. is too much. Permanent kidney damage may develop in 10 percent of children with urinary tract infections, 25 percent of children with recurrent urinary tract infections, and 30 percent of children with vesicourethral reflux (urine leakage into the kidneys). The most common symptoms are fever with chills, flank pain, severe nausea and vomiting. In addition to these symptoms, symptoms of cystitis (symptoms listed above)may be observed.
How is the diagnosis made?
Urinary tract infection is diagnosed. Urinalysis and urine culture should be performed for Urine is first examined under a microscope. Definitive diagnosis is made by growing a significant amount of bacteria in the urine culture. When urinary tract infection is proven by urine culture, it should be decided whether the kidney is involved or not. High fever, flank tenderness, abdominal pain, nausea, vomiting, and tremors may be observed.
How Are Children with Urinary System Infection Evaluated?
Urinary system infection proven by culture. Children with this condition should be evaluated radiologically as soon as possible, and if there is an underlying anatomical disorder, further investigations should be carried out and followed up by a pediatric nephrologist. The younger the age at diagnosis of infection, the higher the risk of recurrence, and the higher the likelihood of kidney damage and permanent kidney failure in the future with each infection. Unfortunately, in our country, recurrent urinary intestines and vesico ureteral fetus still rank first among the causes of chronic renal failure in children.
How is it treated?
Children with urinary tract infection Antibiotic treatment should be started immediately. Effective treatment minimizes the risk of urinary system damage. Treatment for severe infections 10-14 should last a day. In children. Regular follow-ups should be done after treatment due to the difficulty in detecting urinary symptoms and the possibility of recurrence of infection, especially in girls, despite normal radiological examinations after appropriate antibiotic treatment.
What should be done to protect against urinary tract infections in children?
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• Children should be given enough liquid to ensure that the urine is light in color.
• The child should be allowed to urinate 3-4 times a day.
• The child should stay in the toilet for a sufficient time. It should not be done in a hurry.
• The genital area should be washed with pure water, not soap or shampoo.
• In girls, the genital area should be cleaned from front to back.
• Precautions should be taken against constipation.
• Especially For girls, bath time should not be too long and irritating foam soaps and shampoos should not be used. • If there are recurrent infections, further investigations should be done. Research should be done.
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