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Urinary tract infection
Alternative namesBladder infection; Cystitis; UTI
DefinitionA urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract -- the kidneys, the ureters (the tubes that take urine from each kidney to the bladder), the bladder, or the urethra (the tube that empties urine from the bladder to the outside).
Causes, incidence, and risk factors
Cystitis, a common condition, is usually caused by a bacteria from the anus entering the urethra and then the bladder. This leads to inflammation and infection in the lower urinary tract.
Certain people are more likely to get UTIs. Women tend to get them more often because their urethra is shorter and closer to the anus. Elderly people (especially those in nursing homes) and people with diabetes also get more UTIs.In addition, the following risk factors increase the chances of getting a UTI:
Some children develop UTIs. In boys, they are most common before the first birthday. UTIs are more common among uncircumcised boys. In young girls, UTIs are most common around age 3, overlapping with the toilet training period.
Cystitis in children can be promoted by abnormalities in the urinary tract. Therefore, children with cystitis, especially those under age 5, deserve special follow-up to prevent later kidney damage.
The symptoms of a UTI include:
Young children with UTIs may only have a fever, or even no symptoms at all.
Additional symptoms may include:
Signs and testsTests generally include taking a urine sample:
TESTING IN CHILDREN
Because many children with cystitis have something abnormal about their anatomy that predispose them to infections, because these infections are usually preventable, and because the long-term consequences of repeated urinary tract infections in children can be quite serious, many children with cystitis need special imaging studies to determine why they got a urinary tract infection.
These studies usually include both an ultrasound of the kidneys and an x-ray taken during urination (called a voiding cystourethrogram or VCUG).
Most experts recommend this evaluation for:
A mild case of cystitis may resolve on its own without treatment. Because of the risk of the infection spreading to the kidneys, however, antibiotics are usually recommended. It is important that you finish the entire course of prescribed antibiotics.
In children, cystitis should be treated promptly with antibiotics to protect their developing kidneys. In the elderly, prompt treatment is recommended due to the greater chances of fatal complications.
Commonly used antibiotics include:
Most non-elderly adult women only need 3 days of antibiotics. If the infection has spread to one of the kidneys, you may need hospitalization to receive hydration and antibiotics through a vein.
A chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection . Antibiotics may need to be given for a long period of time (as long as 6 months to 2 years), or stronger antibiotics may be needed than for single, uncomplicated episodes of cystitis.
Use of low-dose antibiotics on a daily basis may be recommended to prevent UTIs if you get frequent infections.
Phenazopyridine hydrochloride (pyridium) may be used to reduce the burning and urgency associated with cystitis. In addition, acidifying medications such a ascorbic acid may be recommended to decrease the concentration of bacteria in the urine.
If an anatomical abnormality is present, surgery to correct the problem may be recommended.
Expectations (prognosis)Cystitis is uncomfortable, but usually responds well to treatment.
Calling your health care provider
Call your doctor if you, or your child, have symptoms of a UTI. Call right away if there is fever or chills, back or side pain , or vomiting. These symptoms suggest a possible kidney infection.
Also call if:
If you are prone to UTIs, your doctor may recommend taking antibiotics more regularly to prevent infection.
Update Date: 10/19/2003Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma., and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Alan Greene, M.D., F.A.A.P., Chief Medical Officer, A.D.A.M.; Clinical Assistant Professor, Department of Pediatrics, Stanford University School of Medicine; Attending Physician, Packard Children's Hospital at Stanford (3/3/2002).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT