In a child with a fever, always consider and exclude a UTI, unless there is a clear alternative source of infection

80% of UTIs are caused by E.coli

Epidemiology:

Urinary tract infections (UTI) are more common in boys until 3 months of age (due to more congenital abnormalities) after which the incidence is substantially higher in girls. At least 8% of girls and 2% of boys will have a UTI in childhood

Risk factors:

• poor hygiene
• constipation - affects emptying of bladder
• Neurogenic bladder
• Any structural abnormalities that affect urine outflow
• catheterisation

PC

Presentation in childhood depends on age:

• infants: poor feeding, vomiting, irritability
• younger children: abdominal pain, fever, dysuria
• older children: dysuria, frequency, haematuria
• features which may suggest an upper UTI include: temperature > 38ºC, loin pain/tenderness
• Other Sx: foul smelling urine