Definition and causes
Urinary tract infection is an expression of a bacterial infection of urinary tract . There must be a certain amount of bacteria present, before we call it an infection. If there are no symptoms, but many bacteria, called for the stateasymptomatic bakteriuri.
Urinary tract infection can be divided into a high-or upper form (nyrebækkenbetændelse,pyelonefrit) And a low or lower form (cystitis).
Urinary tract infection is frequent in children. 7.8% of girls and 1.6% of all boys in 7 years of age had at least one urinary tract infection. It is most frequently before 1 year of age, especially among boys. Most of these cases, the upper urinary tract infection.
Infection occurs because the bacteria are transported back up through urinary tract from the urethra to the bladder and possible. then onwards through urinlederne to nyrebækkenet. The bacteria usually comes from the gut. The most common isE. ColiBut alsoKlebsiellaandProteuscan cause urinary tract infection.
Different conditions may increase the risk of getting urinary tract infection. The most important are:
- Misdannelser of the urinary tract, which inhibits the evacuation of the bladder.
- Vandladningsforstyrrelser. incontinence with poor emptying the bladder.
- Defect closure between bladder and urinlederne can cause reflux of urine in urinlederen against nyrebækkenet (vesikoureteral reflux) And increase the risk of upper urinary tract infection.
Symptoms of urinary tract infection
The symptoms depend on whether it is an upper or lower urinary tract infection, and of how serious the infection is.
Upperurinary tract infection is characterized by:
- Fever over 39 ° C.
- Lænde or abdominal pain.
- Activated general: Displays, for example. by fatigue, weakness, lack of interest and irritation.
Lowerurinary tract infection is found at:
- Incontinence .
- An outbreak, very strong vandladningstrang ( Urge ).
- Pain by urination (Dysuri).
- Frequent vandladninger (Pollakisuri).
- No fever or affected the general conditions.
In children under 2 years can be symptoms of urinary tract infection be ukarakteristiske with, for example. diarrhoea, gylpetendens and skrigeture. Therefore we should always suspect upper urinary tract infection in a child with fever without other obvious cause.
Precautions and diagnosis
If your child develops symptoms of urinary tract infection, one should consult a doctor for the purpose of diagnosis and treatment. The doctor suspected urinary tract infection on the basis of medical history and examination of the child. One can examine a urine for the presence of bacteria through urinstiks . If it shows signs of bacteria, the urine should be cultivated to identify what bacteria is causing the infection.
At the upper urinary tract infection will often take blood samples. This will explore the various parameters for the detection of bacterial infection. At the same time will send blood to cultivation for any. bacteria in the blood.
Children under 2 years and children with upper urinary tract infection should be admitted to a børneafdeling for examination and treatment.
Consideration of a urinary tract infection
Urinary tract infection treated with antibiotics. It often starts treatment before we know the operative bacterium. So choose an antibiotic that acts on the most likely bacteria. If the investigation of the urine shows that the infection caused by a bacterium, as the chosen antibiotic against expectations does not work, change the treatment to another that acts on the bacterium.
Lower urinary tract infection can usually be treated with tablets or oral in some. 5 days.
Upper urinary tract infection and urinary tract infection in children under 2 years should be treated in hospital. This will give antibiotics directly into a vein, until the condition is improved, the child has feberfri in 1-2 days, and blood shows that the treatment works. Then you can often switch to oral or tabletbehandling. Treatment is 7 to 10 days.
Select and complications
Lower urinary tract infection which is usually no complications. In severe upper urinary tract infection can spread bacteria into the blood and cause blood poisoning ( Sepsis ), Which is a serious and potentially life-threatening condition. At the upper urinary tract infection, there is also a risk of the emergence of damage to the kidney with arvævsdannelse. Nyreskader can provide renal impairment and also increase the risk of high blood pressure.
The risk of kidney damage can be increased by malformation of the urinary tract, vesikoureteral reflux (see definition and causes above), age less than 2 years, repetitive upper urinary tract infections and late treatment. Therefore, all children under 2 years with urinary tract infection and all children with upper urinary tract infection and examined for the previously mentioned risk factors. It will often perform a ultrasound of the urinary tract under the Notes. 4-6 months later will follow up with a ravsyre-skintigrafi, there is a special scan that can detect if any. arvæv kidney.
Prevention of urinary tract infection
In conditions where there is an increased risk of upper urinary tract infection, will be very aggressive in the diagnosis and treatment to reduce the risk of kidney damage. Parents are instructed in danger and possible action. We examine the urine for bacteria at the slightest suspicion. Some may have long-term preventive antibiotic treatment.