The urinary tract consists of the kidneys, ureters, bladder and urethra.
An infection in the urinary tract is divided in to upper and lower infections with regards to location. The upper urinary tract infections are located in the kidneys and lower infection in the bladder. An infection in the upper urinary tract is considered to be complicated, and a lower urinary tract infection in an otherwise healthy individual is considered uncomplicated.
UTIs are mainly caused by bacterias found in the fecal flora. Various research papers state that 80 – 85 % of the UTIs are caused by the bacteria Escheria coli.
Symptoms in adults of a lower UTI are dysuria (painful urination) often in combination with higher frequency, lower abdominal pain and blood in the urine. These symptoms may also be present in upper UTIs as well as back and/or flank pain, fever, nausea and vomiting. In adults one of the major risk factors is sexual intercourse.
Symptoms in children are mainly the same as for adults. However, in children younger than 2 years, the only symptom can be fever and a general discomfort.
By school age a Swedish study reports that 7.8% of girls and 1.6% of boys have had a symptomatic UTI. Other studies show that about 50-60 % of adult women report that they have had a UTI some time during their life. The frequency of UTIs in adult men is much lower than in women.
Further investigation may include various tests of the urine, such as urine dipstick and urine culture. In complicated UTIs it might be necessary to take ultrasound or CT of the urinary systems. In severe cases hospitalization might be needed. Symptoms of infections in the urinary tract may also represent an STD (sexually transmitted disease) and require tests accordingly.
In children the recommendations with regards to routine imaging with renal ultrasonography and voiding cystourethrogram given in the online medical journal called UpToDate are as follows:
* Girls younger than 3 years age with a first UTI
* Boys of any age with a first UTI
* Children of any age with febrile UTI
* Children with recurrent UTI (if not previously imaged)
* First UTI in a child with a familiy history of renal disease, abnormal voiding pattern, poor growth, hypertension, or abnormalities of the urinary tract.
The main reason for doing imaging is to discover any possible abnormalities in the urinary tract causing infections.
Both uncomplicated and complicated UTIs are treated with various antibiotics. A urinary bladder infection can ascend and become a complicated infection. A complicated urinary infection can cause permanent renal damage. The infection it self can also spread causing urosepsis, a state where bacterias have spread in to the bloodstream which can lead to multi organ failure and possibly be lethal.
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