Detection and diagnosis of UTIs in children

In very young children and infants, UTIs can be challenging to detect because the child is unable to describe exactly how they feel.

They can be more difficult to examine, as well. Therefore, signs and symptoms to look out for include:

• Change in appetite
• Vomiting or diarrhea
• Strong-smelling, cloudy or bloody urine

Older children may report:

• Pain on urination
• Pain in the back or side
• Frequent or urgent urination

When an infection rises to the kidney (pyelonephritis), it is often associated with fever. For this reason, it is very important to investigate any child with unexplained fever for the presence of a UTI. It is estimated that around 5% of children between two months and two years of age with unexplained fever will be diagnosed with a UTI.^{1, 2}

If a UTI is suspected, a specimen of the urine should be collected and tested for the presence of bacteria. The physician may also look for cloudiness of the urine, and test a sample using a dipstick. This will give an initial indication of whether or not an infection may be present. However, there is a large potential for false positive results using a dipstick. A urine culture is the only robust method of diagnosing a UTI.