DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20212467

Urinary tract infection in children presenting with diarrhea

Avinash Singraiah, Pavan Hegde

Abstract


Background: Urinary tract infection (UTI) are the 3rd most common bacterial infection in infants and young children in developing countries after those of respiratory and gastrointestinal tract infection. Because of nonspecific signs and vague symptoms in very young children, they may remain unrecognized. Rapid evaluation and treatment of UTI is important to prevent renal parenchymal damage and renal scarring that can cause hypertension and progressive renal damage. Since gastroenteritis is rampant in developing countries demonstration of an association between UTI and diarrhea will be of clinical significance. The objective of this study was to estimate the prevalence of UTI in children presenting with diarrhea and to identify the clinical co-relates which may guide to identify children with UTI.

Methods: This was a descriptive observational study done in 120 children meeting the inclusion and exclusion criteria, who were admitted in the paediatric ward in father Muller medical college hospital for a period of 1 and a half years. After obtaining an informed consent, a detailed clinical examination was performed on children meeting the inclusion criteria and the data was entered to the preformatted sheet. Urine samples were obtained from all the patients by clean catch mid-stream urine sample, following which urine culture was done for all the children.

Results: In the present study, out of 120 children presenting with Diarrhea 17% had UTI. E. coli (15 cases) was the most common organism isolated in urine culture followed by Enterococcus. Out of 20 UTI cases, 15 were in the age group of 6 months to 1 year followed by 4 cases among 1-3-year age group.18 out of 20 UTI cases were females. Male:female ratio of UTI patients was 1:9.

Conclusions:  UTI in young children can present with diarrhea and other nonspecific symptoms. Children presenting with diarrhea need to have a urine analysis and urine culture for the confirmation of UTI, so that long term complications like renal parenchymal damage and hypertension can be prevented.


Keywords


Urinary tract infection, Diarrhea, Urine culture

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References


Felton JM, Harries AD, Beeching NJ, Rogerson SJ, Nye FJ. Acute gastroenteritis: the need to remember alternative diagnoses. Postgraduate Med J. 1990;66(782):1037-9.

Hari P, Srivastava RN. Urinary tract infection. In: Srivastava RN, Bagga A, editors. Pediatric nephrology 5th ed. New Delhi: Jaypee Brothers. 2011;273-300.

Thakar R, Rath B, Prakash SK, Mittal SK, Talukdar B. Urinary tract infection in infants and young children with Diarrhea. Indian pediatr. 2000;37(8):886-9.

Balat A, Hill L. Infectious Diseases concomitant with Urinary tract Infections in Children. Turkish J. of Medical Sciences.1999;9;65-8.

Srivaths PR, Rath B, Prakash SK, Talukdar B. Usefulness of screening febrile infants for urinary tract infection. Indian Pediatr. 1996;33:218-20.

Narayanappa D, Rajani H, Sangameshwaran A. Study of Urinary Tract Infection in Infants and Young Children with Acute Diarrhea. Indian J Public Health Res Development. 2015;6(2):226-9.

Fallahzadeh MH, Ghane F. Urinary tract infection in infants and children with diarrhea. La Revue de Sante de la Mediterranee orientale. 2006;12(5):690-4.

Bagga A, Tripathi P, Jatana V, Hari P, Kapil A, Srivastava RN et al. Bacteriuria and urinary tract infections in malnourished children. Pediatr nephrol. 2003;18(4):366-70.

Jeena P, Coovadia H, Adhikari M. Probable association between urinary tract infections (UTI) and common disease of infancy and childhood: a hospital-based study of UTI in Durban, South Africa. J Trop Pediatr. 1996;42:112-5.

Dharnidhar Ka VR, Kandoth PW. Prevalence of bacteriuria in febrile infants. Indian Pediatr.1993;30:987-90.

Uppal SK, Srivastava VK, Mullivk P, Vaishnava S. Association of gastroenteritis with urinary tract in infancy. Indian Pediatr 1975;12:159-60.

Pryles CV, Luders D. The bacteriology of urine in infants and children with gastroenteritis. Pediatrics. 1961;28(6):877-85.

Stamey TA, Timothy M, Millar M. Recurrent urinary infection in adult women: The role of introital enterobacteria. Calif Med. 1971;1:155-9.