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Suspecting A Urinary Tract Infection: Overview
by Lynn Cates, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.
It's easy to suspect that your child might have a urinary tract infection (UTI) if she says it burns when she pees and feels as if she has to go every few minutes. However, it is likely that her only symptoms of a urinary tract infection are an unexplained fever or other general complaints. It's important to recognize that your child has a urinary tract infection because it may be the first indication of an abnormality that if left undetected can lead to recurrent infections and serious kidney damage. The only way to be certain of the diagnosis is to perform a urine culture, but several clues may lead you to suspect your child has a urinary tract infection-especially if she has had one before.
General signs and symptoms
Some general signs and symptoms your child may have with a UTI include:
- Fever. Fever can vary widely with urinary tract infections. Your child may not have any fever at all, or she may have a high fever and shaking chills. The severity of the fever is not a very reliable way to tell what kind of urinary tract infection she has but, in general, the higher the fever (over 102.2 degrees Fahrenheit or 39 degrees Celsius), the more likely she has an upper-tract infection (e.g., infection of the kidneys, also known as pyelonephritis), and low-grade fevers (less than 100.4 degrees Fahrenheit or 38 degrees Celsius) are more commonly found with lower-tract infections (e.g., bladder infections, also known as cystitis).
Approximately one out of every 20 children age two months to two years with an unexplained fever will have a urinary tract infection. Since this is the group at highest risk for having undetected urinary tract abnormalities, and for developing permanent kidney damage from recurrent urinary tract infections, it is very important that their urine be evaluated for infection anytime they have an unexplained fever.
- Looking sick. In newborn infants, this may be the only clue that something is wrong since they are less likely than older infants and children to be able to mount a fever response to infection.
- Irritability. If your child is irritable, look for signs that she may be particularly fussy when she is peeing.
- Gastrointestinal symptoms. Stomachache, or full-blown abdominal pain, vomiting and diarrhea, or a poor appetite may be the only signs there is something wrong with your child when she has a urinary tract infection.
- Weight loss. This can result from a loss of fluids with vomiting and diarrhea, or a true loss in body mass from her poor appetite.
- Tired and less active. She may just seem tired and droopy with her infection.
- Trouble sleeping.
Urinary tract signs and symptoms
These are usually more readily apparent in older children, but also can be recognized sometimes in infants and toddlers:
- Changes in her pattern of urinating. You may notice that your infant is needing to be changed more often, or that just when you thought your toddler was finally toilet trained, she regressed and starts having accidents, or wetting the bed again. Likewise, recent onset of daytime accidents or bedwetting in a pre-school or school-age child who was toilet trained long ago should be brought to the attention of her healthcare provider because this may be her only indication of a urinary tract infection.
- Pain, stinging or burning on urination. This is known as dysuria, and is caused by irritation of the urethra (urethritis) in boys or girls, or labia (vulvitis) in girls. A younger child may cry when she urinates, and an older one may tell you it hurts to pee.
- Frequency. She may feel like she needs to pee as often as every few minutes.
- Urgency. She may feel like she has to go right away, even if she just emptied her bladder a few minutes earlier.
- Hesitancy. Your child may be reluctant to urinate because she knows it will hurt.
- Vaginal itching, redness or irritation. These may be signs of vulvitis or urethritis which can predispose your child to an ascending urinary tract infection.
- A foul odor to the urine. You may notice a strange new odor to her urine.
- A dark color or reddish tinge to the urine. This may indicate blood in the urine.
- Back or flank pain may signify a kidney infection and should be taken seriously and your child's healthcare provider notified-particularly in the presence of a fever and/or any specific signs of a urinary tract infection.
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Created February 28, 2001
Reviewed March 12, 2001
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