Urinary Tract Infection – Cystitis: A-to-Z Guide from Diagnosis to Treatment to Prevention

Urinary Tract Infection – Cystitis


When adults get urinary tract infections (UTIs), they typically report burning with urination. Young children, however, may not offer such easy clues.

What is it?

Infections of the urinary tract are common in young children. Bacteria may enter the urinary tract from the opening and travel upward. Less commonly, they may enter the urinary tract through the bloodstream.

If the infection is in the bladder, it is called cystitis. If it is in the kidney, it is called pyelonephritis.

E. coli, a type of stool bacteria, is the most common cause of UTIs. Many other types of bacteria can cause infections. Even viruses, such as adenovirus, can infect the bladder.

Who gets urinary tract infections?

UTIs are more common in girls, because the short, straight trip up to the bladder is easier for bacteria to traverse. About 1 in 20 girls develop urinary tract infections, most commonly around the age of toilet learning.

The most common age for boys to get UTIs is before the first birthday. Uncircumcised boys get more urinary tract infections than their peers.

What are the symptoms of urinary tract infections?

Bladder infections can cause lower abdominal pain, increased urination, uncomfortable urination, tenderness over the bladder, blood in the urine (hematuria), or a fever. In young children, the only symptoms noticed might be fussiness and perhaps a fever. Perhaps the urine will look or smell different than usual.

A high fever (or a febrile seizure) suggests pyelonephritis.

Sometimes bacteria in the urine are discovered only on a screening urine test. In retrospect, they may have been causing symptoms, such as bedwetting, that weren’t recognized.

Are they contagious?

UTIs are not usually spread from person to person, but are caused when stool bacteria makes it into the opening where urine emerges.

How long do urinary tract infections last?

Most UTIs clear up quickly – within days – when the appropriate antibiotics are started.

How are they diagnosed?

UTIs are diagnosed with urine cultures. They may be suggested by the history and physical exam or by a urinalysis test.

How are urinary tract infections treated?

Most urinary tract infections are best treated promptly with antibiotics to prevent possible damage to the kidneys.

The cultured urine will be tested against several antibiotics to see which work best against that specific strain of bacteria. Treatment should not be delayed to wait for this result. It should be started immediately and switched if necessary when the antibiotic sensitivity results are available.

How can urinary tract infections be prevented?

Some UTIs can be prevented by reducing exposure to stool. This means changing diapers promptly, and in older girls, teaching them to wipe from front to back.

Most young children who have had a UTI should have imaging studies performed to look for urine reflux (urine that flows upward at times toward the kidney) and to look for any abnormality in the urinary tract. The studies could also identify any scarring that may have occurred.

Depending on the results of these studies, specific medicines or surgery may be needed to prevent further urinary tract infections.

Related concepts:

UTI, Cystitis, Bladder Infection

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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