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What is a urinary tract infection (UTI)?

A urinary tract infection (UTI) is a bacterial infection in the urinary tract that can cause discomfort and complications in your child if left untreated. There are several more common types of UTIs:

  • Urethritis — an infection of the urethra

  • Cystitis — a bacterial infection in the bladder that often has moved up from the urethra

  • Pyelonephritis — a urinary infection of the kidneys that is usually a result of an infection that has spread up the tract, or from an obstruction in the urinary tract

Facts about UTIs in children

  • Urinary tract infections aren’t very common in children who are not yet toilet trained, so if your baby has one, it’s important to do further testing.
  • UTIs are more common in girls, because girls have a shorter urethra.
  • Uncircumcised boys are more likely to develop a UTI than circumcised boys.
  • Children with a complete or partial blockage in the urinary tract are more likely to develop UTI.

What are the symptoms of a urinary tract infection?

Each child is different. Some of the urinary tract infection (UTI) symptoms your child may experience include the following:

Babies

Older children

  • urgency to urinate
  • incontinence during day and/or night
  • frequent urination
  • painful or difficult urination
  • discomfort above the pubic bone
  • blood in the urine
  • foul-smelling urine
  • nausea and/or vomiting
  • fever
  • chills
  • pain in the back or side below the ribs
  • fatigue
  • small amount of urine while voiding despite feeling of urgency

What causes a urinary tract infection?

A urinary tract infection (UTI) occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra, the hollow tube that carries urine from the bladder to the outside of the body, and travel back into the bladder where they begin to multiply. Most infections arise from Escherichia coli (E. coli) bacteria, which normally are found in the colon.

Care for UTIs

Boston Children’s Hospital UTI experts will work with you to ease your child’s discomfort and find a solution to the infection and any resulting complications. Our specialists diagnose, treat and care for infants, children and adolescents with issues affecting the urinary tract, bladder and kidneys. Explore UTI treatments.

UTI | Diagnosis & Treatments

How is a urinary tract infection diagnosed?

Your child's physician may diagnose a urinary tract infection (UTI) based on a description of symptoms and a physical examination.

Other studies may include a urinalysis (a laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein) and a culture that can detect the presence of an infection.

Children with a confirmed urinary tract infection may require further diagnostic testing with a renal and bladder ultrasound. This is a diagnostic imaging technique that uses high-frequency sound waves and a computer to image the urinary tract.

If your child has a fever and a urinary tract infection, one of the following tests may be needed to evaluate the bladder and urethra as well as to detect possible vesicoureteral reflux (in which urine backs up to the kidneys instead of flowing out through the urethra):

  • Voiding cystourethrogram (VCUG) — A specific x-ray that examines the urinary tract. The images will show if there is any reverse flow of urine into the ureters and kidneys and how well the bladder empties. It’s also used to determine if there is obstruction in the urethra.
  • Radionuclide cystogram (RNC)— An RNC is similar to a VCUG except a different fluid is used.

How are urinary tract infections treated?

Treatments for urinary tract infections (UTIs) may include:

  • antibiotics
  • a heating pad or medications (to relieve pain)
  • increased fluid intake (especially water)

Your child's physician may ask you to bring your child back into the office for a re-evaluation a few days after treatment starts.

How are urinary tract infections prevented?

Ensure that your child is voiding regularly (every two to three hours) and takes the time to completely empty the bladder. Teach your child to wipe his or her bottom from front to back.

If your son is uncircumcised, he should be taught how to retract the foreskin on his penis and clean himself. However, his foreskin should never be retracted forcibly. And make sure that he knows to not allow the foreskin to stay retracted for long periods as this may shut off the blood supply to the head of the penis causing pain and possible injury.

UTI | Programs & Services