43861 - Urinary tract infection in children Professor...

Info iconThis preview shows pages 1–7. Sign up to view the full content.

View Full Document Right Arrow Icon
Urinary tract infection in children Professor Abdelaziz Elamin University of Khartoum Sudan
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Urinary tract infections (UTI) is common in the pediatric age group. Early recognition and prompt treatment of UTI are important to prevent progression of infection to pyelonephritis or urosepsis and to avoid late sequelae such as renal scarring or renal failure. Infants and young children with UTI may present with few specific symptoms. Older pediatric patients are more likely to have symptoms and findings attributable to an infection of the urinary tract. Differentiating cystitis from pyelonephritis in the pediatric patient is not always possible, although children who appear ill or who present with fever should be presumed to have pyelonephritis if they have evidence of UTI. Introduction
Background image of page 2
UTI  generally  begins  in  the  bladder  due  to  ascending  infection  from  perineal  contaminants,  usually  bowel  flora  such  as  Escherichia  coli.  In  neonates,  infection  of  the  urinary  tract  is  assumed  to  be  due  to  hematogenous  rather  than  ascending  infection.  This  etiology  may  explain  the  nonspecific  symptoms  associated with UTI in these patients.  After the neonatal period, bacteremia is not the usual cause of UTI.  The bladder is the initial primary locus of infection with ascending  disease  to  the  kidneys.  Bacteremia  may  then  appear  as  potential  sequelae. Bacterial invasion of the bladder with overt UTI is more  likely to occur if urinary stasis or low flow conditions exist. This is  triggered  by  infrequent  or  incomplete  voiding,  reflux,  or  other  urinary tract abnormalities.  Pathophysiology
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Pathophysiology/2 Even in the absence of urinary tract abnormalities, cystitis  may lead to vesicoureteral reflux, and it may worsen a pre- existing  reflux.  Untreated  reflux  causes  pyelonephritis.  Chronic or recurrent pyelonephritis results in renal damage  and scarring that may progress to chronic renal failure.  Prevalence varies based on age and sex
Background image of page 4
Generalized bacteremia or sepsis may follow UTI. Approximately 30% of 1- to 3-month-old infants with UTI are at risk of developing sepsis. The risk drops to approximately 5% in patients older than 3 months. If left untreated, simple cystitis may progress to pyelonephritis. More severe cases have the potential for kidney damage, which may lead to hypertension or renal insufficiency. Approximately 5-10% of children with symptomatic UTI and fever develop renal scarring. Clinical Course
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
UTI is more frequent in females than males at all ages with the exception of the neonatal period, during which UTI may be the cause of an overwhelming septic syndrome in male infants younger than 2 months. Uncircumcised males have a higher incidence
Background image of page 6
Image of page 7
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 02/26/2012 for the course PHARM 210 taught by Professor Staff during the Fall '10 term at Rutgers.

Page1 / 29

43861 - Urinary tract infection in children Professor...

This preview shows document pages 1 - 7. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online