Urinary Tract Infections in Children

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Urinary Tract Infections in Children

• Prof. Pushpa Raj Sharma

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The Differences

• Difficult in collecting samples
• Symptoms are non specific
• Associated with congenital anomalies
• Risk of having serious complications
• Risk factors
• Permanent renal damage
• Poor long term prognosis

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The Differences
The risk of recurrence of UTI if infected before
one year Of age is 18 in boys and 48 in girls.
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Prevalence of UTI
Sharma PR et al JIOM (1983)519-22 7.3 of all childhood illness admitted in KCH
Ball CS et al Paediatrics (1999)Vol11143-149 Less than one year Girls6.5 Boys 3.3
Kaushal RK et al Indian Pediatrics(2003) Vol 4 Girls 8.4 Boys 6.1
Kanti Childrens Hospital Monthly data review, 2003 64 of Urinary disease
Hemsagar R 2 months to 2 years with fever (2003) Female 38.7 Male 18.7
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Symptoms

• Fever 80
• Failure to thrive 12-15
• Fainting 6.1
• Fast breathing 6.3
• Fowl smelling urine 43-20
• Feeding problems 83-17
• Frequency of urine 34-12
• Frequent vomiting 48-43
• Frequent constipation 2
• Frequent diarrhoea 8-18
• Rimal H and Sharma K (MD Thesis)

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The Symptoms
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Aetiologial Agents
H.S. Rimal / K.R. Sharma
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Antibiotic Sensitivity of the commonest
etiological agent
Antibiotics sensitivity E.coli
Gentamycin 62.5
Amikacin 55
Cotrimoxazole 60
Nalidixic acid 35
Ciprofloxacin 47.5
Rimal HS
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Complications of UTI

• Acute Pyelonephritis
• Chronic pyelonephritis
• Renal scarring
• Hypertension
• Sepsis

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Investigations for UTI

• Routine urine examination
• Culture
• Ultrasound
• DMSA scanning
• Micturating cystourethrogram
• CT/MRI

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Treatment

• Acute attack oral/IV antibiotics
• Repeated attacks prophylactic
• Surgical treatment