Signs and symptoms
A urinary tract infection may produce either no symptoms at all (silent UTI), or any combination of the following: urgency or frequency of urination; painful urination; dribbling of urine; bedwetting; daytime incontinence (inability to control urination); foul-smelling, cloudy, or bloody urine; fever; abdominal or back pain; vomiting; chronic diarrhea; or redness of the external genitals. If the infection is untreated, the symptoms generally disappear in a few days of weeks, but often return later.
The diagnosis of UTI depends upon a careful physical examination, plus urine tests. In boys, the diagnosis involves a search for an obstruction in the urinary tract. In girls, the search for an obstruction is undertaken only after two or three bouts of UTI or one bout with an infection that is resistant to treatment. In an infant, whether boy or girl, investigation for the underlying cause is always undertaken immediately.
Home care
Any attempt at home treatment is potentially dangerous and may result in a low-grade, destructive infection with no outward symptoms.
• A urinary tract infection, particularly one of a series of infections, commonly produces fever, but few or no other symptoms; the doctor’s physical examination reveals nothing unusual.
• To obtain a urine specimen for analysis or culture, cleanse the genitals and collect the portion at the midpoint of urination. In this way, the urine sample will not be contaminated.
Medical treatment
Your doctor will conduct a complete physical examination, including taking your child’s blood pressure and ordering urine tests. If the urine specimen shows an infection, the doctor will put the child on antibiotics for ten to 14 days. Urine samples will be retested during and after the course of antibiotics.
After your child has recovered from a urinary tract infection, your doctor may recommend X rays to determine if there is a physical abnormality. Sometimes, further X rays and direct examination of the urethra and bladder are necessary. To treat recurrent UTIs that are not due to obstruction, your doctor may prescribe the use of antibiotics constantly or on and off for months or years. To correct an obstruction, your doctor may perform surgery.
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