It is one of the significant medical problem in young children. It is one of the cause for irreversible renal damage in association with abnormalities of the urinary tract and vesicoureteric reflux. In infancy the incidence of UTI is same in boys and girls, since route of infection id soften hematogenous and boys have higher incidence of urinary tract anomalies like posterior urethral valves.

Signs and symptoms

Fever, vomiting, diarrhea, jaundice, poor weight gain, lethargy and occasionally convulsions.
Distal UTI in older children presents with dysuria, Hypogastric pain, frequency and urgency of micturition. Urine will be foul-smelling.

In pyelonephritis there will be fever, chills and rigors, flank pain and toxicity.
Other symptoms like excessive crying or straining during voiding, dribbling and weak or abnormal urine stream and palpable bladder suggest urinary obstruction.

Diagnosis

• Urine routine examination: More than 10 pus cells/cu mm in urine are abnormal.
• Gram stain of the uncentrifuged urine revealing two or more bacteria per oil immersion field suggests significant bacteriuria.
• Urine culture: Urine culture showing 10 to the power of 5/mL.

Treatment

• General measures like intake of large amounts of fluids and empty the bladder frequently to prevent stasis of urine.
• Antibiotics used to treat UTI are Ampicillin, Amikacin, Gentamycin, cefotaxime, ceftriaxone, cefaclor.
• The treatment should be usually continued for 7-10 days.
• An ultrasound abdomen is done to rule out any urological anamolies.
• Urine cultures are done periodically to detect  recurrences, which is common in girls, even with normal urinary tract. Recurrence of bacteriuria with out any symptoms need not be treated. Recurrent UTI in the absence of vesicoureteric reflux or obstruction seldom causes gross scarring of kidney.

Diagnostic imaging studies

• Ultrasound of kidney, ureter or urinary bladder.
• Renal scan.
• Intravenous pyleogram.