Recurrent febrile urinary tract infections (fUTIs)

 

According to a wide range of medical literature, recurrent febrile urinary tract infections (fUTIs) are among the most common severe childhood bacterial infections that have the potential for serious long-term consequences.

Early diagnosis and treatment are important because recurrent febrile UTIs can lead to renal damage, permanent renal scarring, decreased renal function, and end-stage renal disease.

Urinary tract overview

The urinary tract consists of two areas: the upper urinary tract and the lower urinary tract.

The upper tract includes the kidneys and the tubular structure (ureter) that runs from the kidney to the bladder. The lower tract includes the bladder and the urethra, which is the tube through which children urinate.

In most cases, common urinary tract infections involve the lower urinary tract. However, when a fever accompanies a urinary tract infection, this could be a symptom of a febrile urinary tract infection, which increases the risk of kidney involvement.

Further symptoms

Children with recurrent febrile UTIs display various signs and symptoms depending on their age. In general, infants under the age of one have non-specific symptoms such as:

• Fever
• Vomiting
• Lack of energy
• Poor oral intake
• Diarrhoea

Children over the age of five typically have symptoms that may include:

• Pain when the area of the lower back over the kidneys is touched
• Frequent urination
• Painful urination
• Urgent urination
• Fever

After infancy, urinary tract infections that involve only the bladder usually have symptoms specific to the bladder, which makes them easier to treat.

However, if your child has a urinary tract infection and a fever, there is a chance he or she could have a condition called, vesicoureteral reflux (VUR).

VUR is a condition in which urine from the bladder backs up to the ureters. The ureters are the tubes that carry urine from the kidneys to the bladder.

Sometimes when a child has VUR, urine can flow all the way back up into the kidney. This results in an increased risk of renal scarring and associated long-term illness.

Having a fever along with a urinary tract infection is the main indicator that your child may have VUR.

If your child is showing signs of having VUR, it is critical that they see a paediatric urologist.