Problems with the urinary system occur at any age. In children, these diseases are difficult to diagnose. Prevalence depends on gender and age. Girls suffer from 2 to 12 years old, boys - most often in infancy. Treatment of urinary tract infections in children will be effective with timely access to a specialist. It takes place in a hospital under the supervision of a therapist and a urologist for 10-14 days.
Classification
Urology determines infections of the urinary tract in children according to ICD-10, which is necessary to confirm the etiology, morphology, pathogenesis for each individual case. All infectious processes occurring in the organs of education and excretion of urine are assigned codes according to ICD-10 from N00 to N99.
Localization of the inflammation process affects the type of disease. In the upper section, pyelitis and pyelonephritis develop - diseases of the kidneys and ureters. On average - urethritis, in the lower part - cystitis. The urethra and bladder suffer. The period of the disease, which differs in its initial form, repeated and relapse, matters. The second occurs with untreated pathology.
The severity of clinical symptoms will help determine the severity of the course. The light form is accompanied by a low temperature, which practically does not increase. The crumbs have a slight dehydration. Severe form is manifested by sepsis, fever, vomiting.
What are the symptoms of the disease?
Signs of a urinary tract infection in children begin with fever (in almost 90% of cases). If it is not, pay attention to the general condition and additional characteristics. They differ depending on the age of the child, as infants can not always show how they feel. They express pain by crying and banging their legs. Most often noted:
- Poor appetite.
- Pain during urination.
- Turbid urine or blood.
- Vomiting
- Irritability.
With inflammation of the organs in the upper part, arterial hypertension develops, renal damage, scar formation occurs. Complicated urinary tract infections in children up to a year occur with congenital anomalies, higher level vesicoureureral reflux. Pyelonephritis in babies can manifest a slight malaise, fatigue, lethargy. Often this happens in boys under 6 months old and in girls under one year old.
Urinary tract infection in children 2 years old passes under the picture of sepsis. Pyelonephritis is considered when the temperature rises to 39 degrees. A fever lasts more than two days, and other symptoms may not occur. Later, lower back pain is added from one or two sides. Less common is diarrhea, vomiting, and abdominal pain.
With cystitis and urethritis, the fever is practically absent, but pain and burning sensation during urination, pressure in the abdomen are characteristic. The child often goes to the toilet. If urinary tract infections in children are not treated on time, secondary enuresis develops by the age of three. Differential diagnosis will allow early detection of concomitant diseases: balanitis in boys and vulvitis in girls.
Clinical picture
Symptoms differ depending on the severity, localization of inflammation, type of infection and the state of immunity of the baby. They will indicate methods of treatment choice and diagnosis. It is important to pay attention to the little things, as they will indicate not only the degree of the disease, but also the neglect of the state of health and related ailments.
What can be identified urinary tract infections in a child 2 years of life? Pyelonephritis can occur in a baby, regardless of age. It is characterized by intoxication and high fever. First, the appetite is disturbed, then the child completely refuses food. At this age, meningeal symptoms are noted. If in time you do not get a full treatment, a chronic form of renal failure develops.
Cystitis is a disease in which children often want to use the toilet. They can empty the bladder every 10-15 minutes with a feeling of pain and pain. Due to irritation of the mucous membrane, a feeling of incomplete emptying occurs, therefore, urinary incontinence is noted. In infants, urination is absent, the temperature reaches 40 degrees. More common in girls. Untimely treatment leads to pyelonephritis.
Bacteriuria is a disease in which bacteria multiply in urine. They are identified only after laboratory tests. Parents often miss a urinary tract infection in children up to a year, since the baby does not complain. However, urine becomes cloudy, has an unpleasant odor, flakes, impurities and blood appear in it.
Causes of inflammation
Diseases appear due to exposure to enterobacteria, including E. coli. Mycoplasmosis and urogenital chlamydia affect the development. Among the causes of urinary tract infections in children are anemia, immunodeficiency. This includes a violation of urodynamics:
- Pieloectasia
- Dystopia of the kidneys.
- Bladder diverticulum.
- Polycystic
- Urolithiasis disease.
- Maternal infection during pregnancy.
- Ureterocele.
- Synechia of the labia in girls.
- Phimosis in boys.
The presence of pathogenic serotypes in the body, insufficient production of antibodies, ischemia, and operations on the organs of the urinary system are important. Problems arise with dysbiosis, colitis, frequent constipation. Increased risk of developing the disease metabolic disorders. It is necessary to monitor the hygiene of the genitals. The correct washing technique will prevent infection in the genitourinary tract.
Pathogenic flora includes E. coli, which is detected in 80% of children. In addition, the development of urinary tract infections in children is affected by bacteria from the class of enterococcal, staphylococcal. Most often, the disease begins with one pathogen. If immunity is reduced, there are congenital anomalies, several types of viruses take part in the process. In weak babies, a layering of the bacterial infection occurs due to the development of the fungus.
A specific code of urinary tract infection in children in the ICD-10 is necessary for planning diagnostics, selecting preventive measures, and for prescribing treatment. An integrated approach will help fix problems. It includes full-fledged medical treatment, diet and hygiene.
Diagnosis of the definition of diseases
A number of serious surveys are needed. Severity and severity are determined using a blood test. It reflects the content of leukocytes and the level of acute phase proteins. The basis is bacteriological urine culture. With its help, the degree of bacteriuria, susceptibility to antibiotics will be confirmed.
In addition, urine samples for mycoplasmas, ureplasm, chlamydia are prescribed. It is necessary to do an ultrasound of the kidneys, bladder, blood vessels. The picture shows abnormalities of the urinary system and violation of the outflow of urine. With frequent exacerbations, the child during remission do urography using a contrast medium. Confirm damage to the parenchyma of the kidney will help static and dynamic scintigraphy.
Clinical recommendations for urinary tract infections in children are provided by a pediatrician, nephrologist, urologist and gynecologist. Experts prescribe studies on Zimnitsky and Nechiporenko. In the blood, signs of inflammation are manifested by elevated CO, leukocytosis, and alpha globulins. For a specific infection, a PCR sample is taken.
Confirmation Methods
Any problems in the lower urinary system are determined using endoscopy. Cystoscopy and urethroscopy will help detect cystitis, urethritis, abnormalities in the structure of the ureter. Anatomical changes are diagnosed in the form of such deviations:
- Doubled pyelocaliceal system of the kidney.
- Underdeveloped structures.
- Hypoplasia
- Aplasia of the kidney, its absence.
- Enlarged renal pelvis.
Among the functional abnormalities is ureteral reflux with impaired urine outflow. Deviation leads to impaired metabolism in the kidneys. Children are admitted to a specialized department of the urological profile. Here, doctors use test strips to detect bacteria in the urine in just a few minutes. White blood cells are detected using a similar test, sensitive to esterase.
Treatment of diseases in children
Recommendations for urinary tract infections in children should be fully observed in order to achieve a speedy recovery. It will take a comprehensive and individual treatment. With cystitis, medications are taken at home if the mother strictly complies with the doctor’s instructions.
Pyelonephritis can be treated in a hospital. Infants under two years old are strongly recommended hospitalization. Children are given infusion therapy and antibiotics are administered. For pain and fever, bed rest is prescribed. Diet includes frequent consumption of food in small portions. This will reduce the load on the mucous membranes, tubules of the kidneys.
Drug therapy is necessary to treat urinary tract infections in children already at the initial stage. Antimicrobial agents have a wide spectrum of action. With cystitis, medications are taken for at least a week, with pyelonephritis - 10-14 days. If necessary, uroantiseptics are prescribed. To relieve pain, antispasmodics are needed. The course of antibiotics is carried out necessarily, and then they pass repeated tests.
Among the clinical recommendations for urinary tract infections in children is diet. Violation of the kidneys suggests that it is necessary to reduce salt intake, limit the amount of fluid. It is recommended to eat protein and vegetable foods, dairy products. Fatty and fried foods, sour fruits should not be present in the diet. They irritate the mucous membrane. You can not kiwi, grapes, tomatoes, citrus fruits, pomegranate.
Acute forms of diseases: what to do
Treatment of urinary tract infections in children in the form of acute pyelonephritis begins as early as possible. This will avoid the risk of developing renal scarring. On the first day after the determination of UTI, bactericidal antibiotics are prescribed therapy. They are selected based on the obtained diagnostic results. Pay attention to the condition of the child.
Fluoroquinols are practically not used in pediatrics, as the risk of damage to growing joints increases. The drugs are used to treat older children, but not as a first choice. Five days prescribe drugs that are administered subcutaneously or intramuscularly. After this, antibiotics are taken orally.
The initial phase of treatment is the most important, but children often experience vomiting. In this case, drugs such as Cefixime and Cefizox are prescribed. Numerous positive reviews for urinary tract infections in a child received therapy with aminopenicillins or cephalosporins. You will need drugs with antipyretic and anti-inflammatory effects. This includes Nurofen, Paracetamol. For the prevention of seizures give "Diazepam".
In the treatment you need a good rest. The baby should be warm, consume enough fluid, should not feel thirsty. Regular drinking will increase urine output. At this time, there is an output of products of inflammation, limiting the spread of bacteria. Drinks and dishes should be warm. Herbal preparations are recommended if the child agrees to drink them.
What to look for when treating
For the treatment of acute cystitis, the effectiveness of therapy is due to a breakdown of the sensitivity of bacteria. Check urine before prescribing antibiotics. In some cases, the use of chemotherapeutic drugs will be required. The duration of treatment depends on the neglect and stage of the disease.
Children are prescribed drugs for up to 5 days. At this time, there should not be many outdoor games, more bed rest. It is allowed to use fruit drinks and mineral water without gas. Antihistamines are required that reduce the negative effect on the intestines. Physiotherapeutic procedures will help to fix the result and prevent relapse. Well-proven baths with chamomile, calendula and sage.
Prevention and prognosis of the disease
Some children are prone to urinary tract infections. The use of simple complexes will help minimize the risk of their development. Drinking regimen is necessary even for babies. The liquid will prevent constipation, affecting the development of bacteria. If complementary foods have already begun, it is recommended to diversify the diet with vegetables and whole grain products.
Doctors do not recommend giving up breastfeeding. Milk protects the baby from infection. If it is possible to stay on natural feeding, the process should continue as long as possible. Girls do not wash their genitals with liquid soap. When changing diapers, wet wipes are used. Hygiene rules will help prevent the development of bacteria in the urine. However, it is important to contact specialists in a timely manner, so that at the first suspicion of the development of infection, take tests and begin treatment.
It is difficult to predict the course of the disease. There are several factors that affect urinary system diseases:
- Congenital abnormalities.
- Immunity of the baby.
- Drug tolerance.
- Providing full assistance.
Congenital anomalies indicate that an individual consultation with a nephrologist or urologist is required. If the girl already suffered from inflammation of the urinary tract, drugs of the nitrofuran group are indicated. Parents should take care of the health of the babies immediately after birth. They do not allow hypothermia, regularly change the diaper, monitor urination, color and characteristics of urine. It is important to pay attention to the baby's complaints.
In young children, lesions in the urinary organs are especially dangerous. Untimely treatment can lead to damage to the parenchymal tissue of the kidney. In this case, an irreversible reaction develops, followed by tissue damage. Diseases at an early stage are treatable, and constant adherence to the rules will avoid relapse and prevent the development of the chronic stage and complications.