Unexplained fevers in children could likely mean an UTI

  • Fevers in children: An estimated one in seven children ends up in the ER for a fever.
  • Fevers can be caused by serious bacterial infections such as urinary tract infections (UTIs).
  • As one of the most common serious bacterial infections in young children, UTIs have become the “only bacterial infection of concern”.

UTIs are infections of the tube the body uses to pass urine. Women are particularly prone to getting UTIs, with some suggesting that the risk of an UTI throughout a woman’s lifetime can be as high as 1 in 2.

But young children can get UTIs too. And left undiagnosed, UTIs can lead to permanent kidney damage.

In a review published in JAMA Pediatrics, Drs. Cioffredi and Jhaveri comments on the prevalence of fevers in young children caused by UTIs.

Fevers in children are fairly common. One survey estimates that in a year, 15% of ER visits were for children with fevers.

Fevers can be caused by serious bacterial infections, such as from pneumonia, osteomyelitis, and meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae type b. But because of widespread vaccinations since the ’70s, most of these infections have become relatively uncommon.

In contrast, UTIs have taken their place. In vaccinated young children without clear signs of an infection, UTIs have become the most common serious bacterial infection.

“In the vaccinated child aged 3 to 36 months, the only bacterial infection of concern is urinary tract infection.”

Bottom line

  • If your child has a fever but it’s not clear why, rule-out viral infections by checking their vaccination records to make sure it’s up to date.
  • If they are vaccinated, think about UTI as a possible cause of the fever and ask the doctor or nurse about it.
  • UTIs should be diagnosed with a urinalysis and urine culture before treatment.

ER = emergency room.
Source review: Cioffredi L and Jhaveri R. JAMA Pediatr. Published online June 20, 2016. A paid subscription may be required.

Reference: 1. Cioffredi L and Jhaveri R. JAMA Pediatr. Published online June 20, 2016. 2. WebMD. Your guide to urinary tract infections (UTIs). Available at: http://www.webmd.com. Accessed on September 17, 2016. 3. Niska R, et al. Natl Health Stat Report 2010;(26):1–31. 4. Roberts KB, et al. Pediatrics 2011;128(3):595–610.

Photo adapted from original by Marcin Bajer, used under license.

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