Urinary tract infection in children: causes, symptoms, treatment
Urinary tract infections (UTI) are one of the most common diseases in children under one year, second in frequency only to upper respiratory tract. The high prevalence is due to the difficulty in diagnosis and symptoms common to many diseases. The symptoms of the disease are not always typical lesions of the urinary system, ranging from fever to violations of the digestive tract.
If untreated, the inflammation progresses rapidly, becoming complicated renal parenchyma, renal scarring, sepsis, hypertension and chronic renal failure.
The causes of the disease
It is worth noting that inflammation is more common in girls. This is due to anatomical features: the proximity to the vagina, the intestines, the urethra is short. The impact of gynecological diseases (D. vulvovaginitis, vulvitis).
Most girls get sick at the age of 3-4 years. Boys are more prone to infections in infants, and the reason usually is any congenital abnormality of the genitourinary system. Inflammation of the urinary tract can develop in infants due to improper use of diapers and lack of hygiene.
The infection can enter the body in three ways:
- Rising directly through the urethra, hitting the bladder and then the kidneys;
- Hematogenous when it boils, sepsis, bacterial endocarditis;
- Lymphogenous from adjacent organs, through lymphatic vessels of the urogenital system and intestines.
Most often, the infection penetrates upward path, the micro-organisms of the intestine are the most common cause of UTI. Often the tests show the presence of Proteus, Klebsiella, enterococci, a little less – streptococci, staphylococci and microbial associations.
Microbial-inflammatory lesions are divided into infections of the lower (urethritis, cystitis) and upper (pyelonephritis, pyelitis) of the urinary tract. As the inflammation of the kidneys, and lesions of the urinary tract in children is called in medicine, the term "urinary tract infection"because it spreads rapidly and it is impossible to determine its localization.
There are several factors that provoke irritation of the mucous membranes of the urinary system as a result of stagnation and delay of urine:
- Anomalies in the structure of reproductive system of children, for instance, the labia minora in females, phimosis in boys;
- Congenital abnormalities of the urinary system, tumors, stones, vesicoureteral reflux;
- A neurological disorder accompanied by functional disorders of urination;
- Violation of metabolic processes;
- Failure to observe the rules of personal hygiene;
- Infection of adjacent organs, worm infestation.
Symptoms caused by urinary tract inflammation
The clinical picture depends on the age of the baby, the localization of the pathology and severity, for example, cystitis pronounced local characteristics (dizuriceskie), frequent painful urination by small portions of urine. There is pain in the suprapubic region. Itself urine becomes cloudy. In infants a possible delay of urination, and older children, incontinence.
With the progression of the disease and kidney disease develops pyelonephritis – inflammation of the pelvis of the paired organ. Signs of the disease include: fever, chills, lethargy, pale skin, headache, loss of appetite, nausea, vomiting, abdominal pain and lower back pain.
Such signs of inflammation of the urinary tract often lead to incorrect diagnosis and incorrect treatment. That is why children who have high fever and vague intoxication, it is necessary to pass a urine test.
If you suspect an infection of the urinary system conduct a comprehensive survey. To find out its severity and urgency, assign clinical analysis of blood. The white blood cell count, erythrocyte sedimentation rate, level ostrogannyh proteins and other substances put in prison.
In urine, usually find protein leukocytes, and sometimes erythrocytes. Also for inflammation of the essential bacterial urine culture to identify the pathogen and determine its sensitivity to antibiotics. The analysis to be accurate, you need to properly collect urine, undermining pre-baby. Going only the middle portion of urine.
Inflammation of the urinary tract requires in children ultrasound. It is necessary to assess the condition of the kidneys. To identify the cause of the violation of the outflow of urine with repeated disease (relapse) may need contrast study – meccinna cystography (for boys under first disease for girls – if you re), excretory urography (recurrent pyelonephritis).
These activities are carried out only in remission. Ultrasonography and urography will allow you to establish the causes of violations of the outflow, the anomaly of the organs, cystography – intravesical obstruction, vesicoureteral reflux.
Treatment in children inflammation of the urinary tract
Therapy consists of a set of measures matched individually. Baby with cystitis can be treated at home, in child with pyelonephritis only in a hospital. Children under 2 years of age always hospitalitynet, since they need of infusion therapy and parenteral antibiotics.
Fever and severe pain require compliance with bed rest. To reduce the load on the mucous membranes and kidney tubules, treatment includes diet. It is recommended that a fractional power. When impaired renal function is limited to liquid and salt.
The menu should consist of protein and plant foods, dairy products. Completely eliminate sour, fried, spicy, limit the fruits and vegetables that contain a lot of acid (pomegranates, kiwis, citrus fruits, tomatoes, grapes, peppers, sauerkraut and pickles).
After the relief of pain are shown plentiful drink. This measure is necessary to improve the functioning of the kidneys, as the urine irritates them. Drink allows rid your body of bacteria and their metabolic products. It may be slightly alkaline mineral water, cranberry juice or juice.
Antibiotics are the primary medication for inflammation of the urinary tract. The medicine selected on the basis of the causative agent, its sensitivity to drugs of this series. The role played by the individual characteristics of the baby.
The tool should not be nephrotoxic. Pending the results of bacterial seeding urine, antibiotics are widely-spectrum – cephalosporins, carbapenems, protected penicillins, aminoglycoside.
The course of treatment cystitis – at least a week, pyelonephritis – not less than 2 weeks. Upon completion, conduct a benchmarking study of urine. Therapy can be supplemented uroantiseptiki. To prevent diarrhea prescribe probiotics.
Prophylactically use herbal remedies. Proven charges, including nettle, bilberry leaf, St. John's wort, rose hips, chamomile flowers, corn silk, yarrow, juniper berries. These plants eliminate the symptoms of inflammation and have diuretic properties.
Pain syndrome relieved by antispasmodics. To enhance the antibiotic therapy used NSAIDs. Frequent relapses require so-called local treatment.
Medicines are introduced into the cavity of the bladder through a catheter. Funds are selected on the basis of forms of the disease: antiseptics, antibiotics, substances with regenerative and cauterizing action. Treatment of chronic cystitis includes measures of physical therapy.
Upon detection of malformations of the urinary system should consult a doctor-urologist for surgical intervention. After the first episode of the disease requires control of doctors, because the high probability of relapse, which, moreover, is often asymptomatic and poses a great threat to the health of the child.
You should regularly test the urine. If no recurrence for 5 years, no malformations of the urinary system, the kidneys perform their function, the child is removed from the dispensary.