Symptoms:

Young children with UTIs may only have a fever, or no symptoms at all.

Symptoms of a UTI in children include:

• Blood in the urine
• Chills with shaking
• Cloudy urine
• Fever
• Flushed, warm, or reddened skin
• Foul or strong urine odor
• Frequent or urgent need to urinate
• General ill feeling (malaise)
• Lethargy
• Nausea
• Pain in the side (flank) or back
• Pain or burning with urination
• Pressure in the lower pelvis
• Severe pain in the belly area
• Urinary incontinence after the child has been toilet trained
• Vomiting

Signs and tests:

A urine sample is needed to diagnose a UTI in children. The sample is examined under a microscope and sent to a lab for a urine culture.

In children who are not toilet trained, getting a urine sample can be difficult. The test cannot be done using a wet diaper. Possible ways to collect a urine sample in very young children include:

• Urine collection bag -- A special plastic bag is placed over the child's penis or vagina to catch the urine; this is not the best method because the sample may become contaminated.
• Catheterized specimen urine culture -- A plastic tube (catheter) placed into the tip of the penis or into the vagina collects urine directly from the bladder.
• Suprapubic urine collection -- A needle is placed through the skin of the lower abdomen and muscles, into the bladder, and used to collect urine.

If this is your child's first UTI, special imaging tests may be done to determine why the infection occured. Tests may include:

• Kidney ultrasound
• X-ray taken while the child is urinating (voiding cystourethrogram)

These studies may be done while the child has an infection, or weeks to several months afterward.

Your doctor will consider many things when deciding if and when a special study is needed, including:

• Is the child younger than 6 months?
• Has the child had infections in the past?
• Is the infection severe?
• Does the child have other medical illnesses?
• Does the child have a problem with the spinal cord or defects of the urinary tract?
• Has the child responded quickly to antibiotics?