BABY AND CHILDHOOD URINARY TRACT DISORDERS: URINARY TRACT INFECTION
‘Jimmy suddenly ran this very high fever,’ Jane said on the phone. ‘I’m awfully worried. He is hot and clammy and looks pale and listless. What’s more, he wants to pass his urine every few minutes. When he does, he squeals as if it’s hurting him. Jimmy hardly ever complains… He is always a happy little chap,’ Jane went on. ‘I think he must have some sort of infection in his bladder…’
Soon afterwards I visited young Jimmy. Certainly, he rarely complained and was usually a bright happy lad. But today he was pale and obviously unwell. He had been off his food for about 24 hours, and his temperature had suddenly shot up, leaving him feeling very miserable. He was sweating profusely, and just before I arrived he had been vomiting slightly—also unusual for Jimmy. Passing his urine was definitely painful, and this immediately suggested an infection in the bladder or kidney region. When I gently prodded below his navel, in the so-called supra-pubic region, he winced. ‘Hurts,’ was all he would say, then he quietly shed a few tears. Similarly, pressure in the lower part of his back, just over his kidneys, was also quite uncomfortable.
‘We shall have a specime of urine checked out,’ I said to Jane. ‘This will tell us exactly the nature of the germ causing the trouble. It will also indicate the best treatment to give. Antibiotics are usually very satisfactory, but a sensitivity test will give us the exact result and indicate the most suitable treatment.’
Treatment
To begin with, doctors often prescribe one, of the ‘broad spectrum’ antibiotics, even before the results of investigation are received. This may start the patient quickly on the path to recovery. Many excellent varieties are now available and the urinary system is very receptive to them.
Plenty of fluids are advisable, for this flushes out the dead germs and general toxins, not only from the system but from the urinary tract in particular. It also replaces the fluids lost from perspiring and sweating.
Powders and granules given in fluid to ‘alkalinize’ the urine are often used, and this is claimed to help. Paracetamol will often reduce fevers and make the patient feel more comfortable and it reduces aches and pains which commonly accompany urinary infections. However, if there is vomiting, the more that is introduced into the stomach the worse the patient feels, so the less the better. Sucking chipped ice or cold drinks are often acceptable, and frequently retained.
Most infections in children affect the bladder region, but they are usually brought under control rapidly. Sometimes, especially if there are recurrences, it may indicate that the kidneys and upper parts of the urinary system (the ureters) may also be infected. It may be necessary to have further and more complete investigations carried out after the child has settled down and the acute bouts are brought under control.
Tests on thousands of children, especially those of school age, shows that many individuals carry around small numbers of germs in their bladders, even though symptoms are not present. Sometimes these can suddenly get out of control and an acute attack supervene. Some doctors believe that all urinary infections, however mild, should be treated.
It is a very important system, and disorders here can lead to more serious ones in later life. It is worth keeping a close check for symptoms and reporting any abnormality promptly to the doctor, for treatment or further investigation.
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Tags: General health