pediatrics
Urinary Tract Infection (UTI) in Children
Symptoms and Signs of UTI in Children
 symptoms and signs of urinary tract infection are nonspecific and include poor feeding, diarrhea, failure to thrive, vomiting, mild jaundice (which is usually direct bilirubin elevation), lethargy, fever, and hypothermia. Neonatal Sepsis may develop. Infants and children<2 yearswith UTI may also present with poorly localizing signs, such as fever, gastrointestinal symptoms (eg, vomiting, diarrhea, abdominal pain), or foul-smelling urine. About 4 to 10% of febrile infants without localizing signs have UTI. Inchildren>2 years,the more classic picture of cystitis or pyelonephritis can occur. Symptoms of cystitis include dysuria, frequency, hematuria, urinary retention, suprapubic pain, urgency, pruritus, incontinence, foul-smelling urine, and enuresis. Symptoms of pyelonephritis include high fever, chills, and costovertebral pain and tenderness. Physical findings suggesting associated urinary tract abnormalities include abdominal masses, enlarged kidneys, abnormality of the urethral orifice, and signs of lower spinal malformations. Diminished force of the urinary stream may be the only clue to obstruction or neurogenic bladder. 