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If baby doesn’t have cough, rhinorrhea or congestive throat but fever doesn’t subside for several days, it’s possible that urinary tract is infected by bacteria. Urinary tract includes kidney, ureter, bladder and urethra. Infection development in above organs is called urinary tract infection.

1. There was no specific clinical presentation, such as jaundice, pale looking, cyanosis, shortness of breath, weight loss, dehydration, irritability, lethargy, convulsion, and appetite; with fever the most common presentation.
2. Routine urinary analysis: white blood count above 5-10 per HPF.
3. Urine culture revealed bacteria: Escherichia coli is the most common, above 80%.

1. Antibiotic usage: cystitis should be treated with antibiotic for 7 days and acute pyelonephritis for 10-14 days.
2. Renal Ultrasonography: for early detection of congenital abnormality such as obstructive hydronephrosis, ureter duplication, and polycystic kidney.
3. Voiding Cystourethrography (VCUG): for diagnosis of intraureteral reflux, vesicoureteral reflux or deformity of urinary tract.
4. Dimercaptosuccinic acid (DMSA): to detect any scar formation in renal cortex due to urinary tract infection.

1. Increase water intake in order to decrease side effect of drug and increase excretion of bacteria.
2. If baby has fever, give baby antipyretic, which was ordered by doctor, and supply water.
3. Keep perineum clean, especially with girls. When clean perineum after toilet, remember to follow the direction from urethra orifice to anus in order to reduce opportunity of urinary tract infection.
4. Boys should clean prepuce and prevent bacterial infection.
5. Avoid bubble bath to prevent soap from stimulating bladder.
6. Observe if baby has distended bladder and urine volume.

Four to six weeks after stopping taking antibiotics, at least 2 times of sterile urine ensure resolution. Regular follow-up is needed.

中國醫藥大學附設醫院

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