Pediatric pyelonephritis, commonly known as a pediatric kidney infection, occurs when bacteria, most often Escherichia coli (E. coli) in 70-90% cases reach the kidney, multiply in numbers and cause infection.
What is Pediatric Kidney Infection (Pyelonephritis)?
A kidney infection, medically known as pyelonephritis or upper urinary tract infection (upper UTI), usually happens when a harmful bacteria or fungi spreads from the bladder to the kidneys. This is in contrast to lower UTI which is infection restricted to the bladder and urethra. Children with pyelonephritis are usually sick, dehydrated, have high grade fever and pain in the flank. Children less than 2 years are particularly susceptible to this condition.
The inflammation can lead to scar formation in the kidney which can subsequently cause poor renal function and hypertension as well. Recurrent acute kidney infections may eventually require a kidney transplant. Very rare instances of deaths due to severe kidney infections are also known. It is thus important to get early medical attention for UTI to avoid potential permanent kidney damage.
What Are the Signs of an Acute Kidney Infection in Children?
Signs of acute kidney infections in children can differ depending on their age:
- Newborns might not have a fever but could show signs like poor feeding and vomiting, decreased urine output.
- Children under 2 years may have a fever (though not always), along with reduced appetite, vomiting, pain in the flank region and diarrhea.
- Children over 2 years are more likely to experience fever, changes in eating habits, pain in the stomach or lower back, unusual tiredness or sleepiness and urinary symptoms such as urgency, frequent urination, pain during micturition.
How Do Kidney Infections Happen in Children?
Pediatric Kidney infections usually start when bacteria enter the body through the urethra (where urine exits) and travel up through the bladder and ureters to reach the kidneys. There are other routes from which bacteria or fungi gain access to the kidneys: blood stream, direct extension from adjacent organs or the lymphatic system.
Certain conditions like bladder dysfunction, blocked urine flow, neurogenic bladder, or vesicoureteral reflux (VUR) where urine travels upwards in reverse direction, as well as the use of urinary catheters, can make children more prone to infections and potential kidney damage.
How Can I Help Prevent a Kidney Infection in My Child?
If your child shows signs of a urinary tract infection (UTI), early medical treatment is important to stop it from spreading to the kidneys. Here are a few prevention tips:
- Timely treatment of UTIs is key.
- Some children are prescribed low dose antibiotics on daily basis at nights, to lower the chance of repeat UTIs.
- Uncircumcised baby boys under one year old have a higher risk of UTIs compared to circumcised boys.
- Surgical correction of treatable causes as determined by your expert pediatric surgeon
How Is a Pediatric Kidney Infection Diagnosed?
Doctors confirm a kidney infection by urine tests and supplemental blood tests in children with symptoms as discussed above. If a child has frequent UTIs with fever, an ultrasound of the kidneys may be done to check for any hidden problems which may be followed by other scans as well.
How Are Pediatric Kidney Infections Treated?
Most children can be treated at home with oral antibiotics. In more serious cases, they may need IV antibiotics in the hospital. Keeping your child well hydrated is crucial—drinking lots of fluids helps flush out the infection and may reduce the risk of long-term kidney damage.
When Should You See a Pediatric Surgeon or Pediatric Urologist?
If the scans show anything unusual about the kidneys or how they function and if there is any surgically correctable cause for acute kidney infection, your child’s doctor may refer you to a pediatric surgeon and pediatric urologist for surgical evaluation and care.
References
https://www.aafp.org/pubs/afp/issues/2011/0215/p409.html
https://my.clevelandclinic.org/health/diseases/15456-kidney-infection-pyelonephritis
FAQ’S for Understanding Pediatric Kidney Infection – Signs, Symptoms, Causes, Prevention, Diagnosis and Treatment Options for Children
A pediatric kidney infection, also known as pediatric pyelonephritis, is an infection that affects the kidneys. It usually starts as a urinary tract infection (UTI) that spreads from the bladder to the kidneys.
Kidney infections in children are typically caused by bacteria, most commonly Escherichia coli (E. coli), that travel through the urinary tract to the kidneys.
Common symptoms include high fever, vomiting, pain while urinating, tummy or lower back pain, chills, tiredness, and frequent or bloody urination.
Yes, if left untreated, kidney infections can cause permanent kidney damage, high blood pressure, or in rare cases, kidney failure.
They are usually diagnosed using a urine test, and in recurrent cases, imaging tests like an ultrasound, and other scans may be done to check for underlying issues.
Most cases of UTI are treated with oral antibiotics at home. Severe infections or kidney infections will require hospitalization and intravenous (IV) antibiotics.
You should consult a specialist if your child has frequent UTIs, unusual scan results, or any structural abnormalities in the kidneys or urinary tract that can be corrected by surgery.
Timely treatment of urinary tract infections, good hygiene practices, and ensuring your child drinks plenty of fluids can help reduce the risk of kidney infections.
VUR is a condition where urine flows backward from the bladder to the kidneys. It increases the risk of kidney infections and may require monitoring or treatment.
Yes, recurrent or untreated infections can lead to kidney scarring, reduced kidney function, and high blood pressure later in life.
Author: Dr. Y.N.V.S Siva Kamesh
Consultant Pediatric Surgeon & Pediatric Laparoscopic Surgeon