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Definition
- A bacterial infection of the bladder
- Also called cystitis
Health Information
Symptoms
- Pain, burning or stinging when passing urine
- Suspect pain if a young child starts to cry while passing urine
- The feeling of "can’t wait" to pass urine may occur. This is called urgency.
- Passing small amounts of urine at a time. This is called frequency.
- New onset of day or night-time wetting
- Pain in the lower abdomen may also be reported. If the kidney is infected, the pain is in the flank. The flank is the side right below the ribs.
- UTIs are a common cause of unexplained fevers in young children.
- The urine may be cloudy and have a bad odor. Sometimes, there is some blood in the urine.
Causes
- UTIs are caused by bacteria that travel up the urethra into the bladder.
- Sometimes, it starts with irritation of the penis opening. Bubble bath or rubbing with soap can do this.
- A rare cause is not emptying the bladder all the way. Reason: Urine that stays in the bladder too long can become infected.
- Cystitis is not common in males. This gender difference may reflect the much shorter length of the female urethra.
Diagnosis
- A clean catch urine sample needs to be tested. A UTI is confirmed by finding white blood cells in the urine. A positive culture for bacteria is also required.
Prevention of Recurrent UTIs in Boys
- When your child bathes, cleanse the genital area with warm water. (Soap is not needed until after puberty)
- Don’t use bubble bath, shampoo or other soaps in the bath water. (Reason: They are irritants.)
- Drink enough fluids each day to keep the urine light-colored.
- Urinate at least every 4 hours during the day and avoid "holding back."
- Avoid constipation.
Care Advice
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Overview:
- Bladder infections are rare in boys.
- Stool holding can be a cause. Reason: These children also often hold back urine.
- Here is some care advice that should help.
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Antibiotic by Mouth:
- UTIs need a prescription for an antibiotic.
- The antibiotic will kill the bacteria that are causing the bladder infection.
- Give the antibiotic as directed.
- Try not to forget any of the doses.
- Give the antibiotic until it is gone. Reason: To keep the bladder infection from flaring up again.
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Pain Medicine:
- For pain when passing urine, give a pain medicine.
- Give acetaminophen (such as Tylenol) or ibuprofen.
- Use as needed.
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Fever:
- For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important forfighting infections.
- For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
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Give More Fluids:
- Give extra fluids to drink. Cranberry juice may be helpful.
- Reason: Dilutes the urine so that it does not sting.
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What to Expect:
- Fever is usually gone in 24 hours.
- Pain and frequency are usually much better in 48 hours.
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Return to School:
- Even if your child has a bladder infection, it cannot be spread to others.
- Your child does not need to miss any school or child care.
Call Your Doctor If
- Pain when passing urine becomes severe
- Fever lasts over 48 hours after starting the antibiotic
- Vomiting and can’t keep down the antibiotic
- You think your child needs to be seen
- Your child becomes worse
Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC