by Nicole Evans M.D.

Created on: October 17, 2009   Last Updated: March 20, 2010

Urinary tract infections can occur in girls and boys of any age. In very young children and infants, it is difficult for a parent to know when their nonverbal child is having symptoms of a urinary tract infection.  The child can't use words to say their belly hurts or it burns when they pee.

However, the ability to detect and treat urinary tract infections in young children and infants is very important. A urinary tract infection at early in life may indicate anatomical abnormalities with the urinary system. In some children, these urinary tract abnormalities may lead to kidney failure later in life if not corrected.

An untreated urinary tract infection that starts in the bladder, termed cystitis, may ascend to infect one or both of the kidneys. An infection of the kidneys is called pyelonephritis, and can cause scarring of the kidneys. This scarring may lead to permanently impaired renal function.

In a worst case scenario, a urinary tract infection may lead to urosepsis in untreated or incorrectly treated children. Urosepsis is a dangerous, potentially lethal, condition in which the infection in the urinary tract reaches the bloodstream and causes an overwhelming inflammatory response of the entire body.

The following risk factors should make you suspect a urinary tract infection in children 2 to 24 months old in whom there is concern for illness:

-Temperature greater than 39 degrees Celsius

-Fever without an apparent source

-Fever for more than 24 hours

-Ill appearance

-Suprapubic tenderness

-Nonblack race (African American race appears to be a protective factor)

-History of a prior urinary tract infection (UTI)

If you are concerned your child is ill and he or she has 1 or more of these risk factors, your physician should get a urine analysis and a urine culture.

The following risk factors should make you suspect a urinary tract infection in greater than 24 months old females or uncircumcised males in whom there is concern for illness:

-Dysuria (discomfort with urination)

-Increased urinary frequency

-Abdominal pain

-Back pain

-New onset incontinence

If your child has 1 or more of these risk factors, your physician should get a urine analysis and a urine culture.

The following risk factors should make you suspect a urinary tract infection in greater than greater than 24 months old circumcised males in whom there is concern for illness:

-Dysuria (discomfort with urination)

-Increased urinary frequency

-Abdominal pain

-Back pain

-New onset incontinence

The probability of a urinary tract infection (UTI) in circumcised males older than 24 months is less than one percent. Therefore, two or more signs and symptoms of UTI must be present to have your doctor justify obtaining a urine analysis and urine culture.

Urinary tract infections in young children are potentially lethal infections, requiring hospitalization, IV antibiotics and imaging studies if severe enough. A parent should never try to diagnose or rule out a urinary tract infection from the above information, leave this task to your child's physician.

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