J.B. asks from Orient, OH on August 05, 2009
Urinary Tract Infection in Baby Girl
Hello. I recently took my 11 month daughter to the doctor because she had a fever of 103 that was not decreasing with motrin or tylenol. The doctor could not find anything wrong with her since she didn't have any symptoms except the fever. She ended up doing a chest x-ray, blood work, and a urine sample. I received a call saying that the x-ray showed bronchitis and that it was viral based on the blood test. I was told to just give tylenol to keep the fever down since that was the only symptom.
A few days later the doctor called back and told me that there was e-coli in my daughters urine and that she had a UTI. I put her on antibiotics because I didn't want her to get any kidney problems that the doctor scared me with. She still hasn't had any symptoms of the UTI or bronchitis. Her fever went done about 2 hrs after the doctor appt and she hasn't had a fever since. Today we had a follow up appt to get another urine sample. The doc told me that my daughter has to have a catscan of the kidneys and some other tests performed at the hospital even if the urine is clean and infection is gone. I am questioning whether all these other tests need to be performed after 1 infection. What if some stool just got in the first urine sample? It just seems like they are taking this too far and getting me worried about nothing. Has anyone else had a similiar situation? Did you get a 2nd opinion before all the other tests?
R.D. answers from Indianapolis on August 06, 2009
I am a nurse in a hospital NICU. We do these tests on any baby who has had a UTI from urine obtained by an in and out catheter. A bagged urine specimen could be contaminated. A cathed specimen, if obtained correctly, shouldn't have contamination. The reason you want to have these tests is to rule out reflux into the kidneys. If urine is backing up from the bladder into the kidneys, it could cause a life-time of problems. Generally, I would say about 1/2 of our kids who have a UTI end up with this reflux problem. They are put on a low dose preventative antibiotic to prevent further infections and damage to the kidneys. You can discuss with your doctor an option to wait until the next bladder infection. But as one poster said, you could have a lot of damage done by then. Usual tests we do are an ultrasound of the kidneys, and then a VCUG.
Good luck. You have to do what you feel is right, and what you can sleep with. I will tell you, when my son was 4, I felt a lump on his abdomen after a small accident. I took him to the ER to get it checked out. The lump was located over his liver. I had a PA tell me it was his diaghram. They took an x-ray, and saw a mass, but my ped, who I just spoke to on the phone wondered if it was stool in his intestine. (She had not seen the x-ray, so was speaking off of the top of her head.) Their CT machine was broke, so they asked me to return in the am. The next morning, I couldn't even feel the lump anymore. But because I wanted peace of mind, and didn't want a problem later, I took him in. Turned out there was a tumor on his liver. 24 hours later, he was in surgery having it removed, and the surgeon prepared us for the worst, Cancer with mets to the lung. Fortunately, we got lucky, and it was a benign thing, rare, and it would have needed to be removed eventually because the liver had started to make room for it. My point is, even if something looks OK, you don't know what's happening under the skin. Peace of mind is wonderful, and knowing you aren't missing something that could have been picked up earlier is great. However, if you find out everything was normal, and will be kicking yourself that you put your child through this unnecessary test, than maybe skipping it is what is best for you. I knew I wanted peace of mind.
Good luck in your decision. Doctors and parents should be partners in their child's care.
1 mom found this helpful
A.F. answers from Columbus on August 06, 2009
Hi, J.. My daughter had her first UTI at the age of 4 months, and I was surprised when my pediatrician (who is very wholistic and noninvasive) referred us for a kidney ultrasound and then the VCUG with the dye. I learned that it is routine with an infant UTI, as the chances are good that your daughter might have vesicoureteral reflux, where the urine backs up into the kidneys. My daughter has it, and while it's a little scary to get a diagnosis, if you're paying attention and working closely with the urologist and your pediatrician, it isn't too difficult to live with. It usually means daily preventative antibiotics, and a catheterized urine sample when your child has a fever, to rule out a UTI. If infections continue, surgery can easily fix the reflux. We are one infection away from our daughter (now 13 months) having surgery, and while that is pretty scary, for pediatric urologists, it is a common problem that they deal with every day. If you're in Columbus, the urology department at Children's Hospital is really great to work with.
M.G. answers from Columbus on August 06, 2009
I see you have lots of replies and I am rushed now so can't read them. I am a neonatal nurse and a mom of a boy who has *renal reflux*.... That is the disorder you generally think of when a baby or child has a UTI. but.... Girls do get UTIs more commonly than boys, so it is a lil controversial as to what to do now. I agree with you that you need to really think it through with what does she *really need* right now. I am not sure why they would want to do a catscan? That is a very expensive test, normally they will do a simple ultrasound to see if there is any damage, but the VCUG is the the *procedure* that will diagnose Renal Reflux to see if any of the urine is beling reflux back up the ureters.. It is invasive in that they place a urine catheter and put dye in it and the radiologist views as the test is perfomed. Speaking of invasiveness --When they checked her urine and diagnosed the ecoli was it by sterile procedure with a catheter or a *clean cathc* most likely it should of been catheter and therefore would not of been accidentally contaminated with stool. One last tid bit, it is much easier to go through the VCUG with am 11 month old than an older child, she will eventually have to have this if she has another infection, the benefit of getting that done now is that you will know if she has it and can get the preventative help she needs to prevent future infections and damage or just feel at ease with knowing she is great and probably just was more prone to the UTI from having her system down due to the bronchitis. Email me if you have any questions!
S. answers from Cincinnati on August 06, 2009
I can only tell you of an 18-month old that I know who by that time had been hospitalized 3 times with UTIs. She had kidney reflux where a valve that stops the urine from backing up into the bladder doesn't close completely(I think - I'm not expert and this was a few years ago). Maybe something like this is what your doctor is looking for. This little girl's mother was determined to not have her baby on constant antibiotic (as she recognized the side effects) and was looking for a way to prevent the UTIs rather than continue to treat them. We were able to do that and eventually the baby grew out of the condition. Otherwise, the doctor was recommending surgery.
Best of luck as you make very difficult decisions. Let them do something to us, but leave our children alone. Right?
S.B. answers from Indianapolis on August 06, 2009
Since she is so young and cannot communicate how she is feeling, I would suggest getting the tests done. Even if everything comes back normal, at least you will have the peace of mind that you made sure. And it doesn't sound like any of the test would cause her pain, so what's there to lose? I do have question though. How do they get a urine sample from babies who are not potty trained? My daughter just turned 2 and had the same symptoms. She had a temperature of 103 and the pediatrician could not find anything wrong with her. She was not given a urine test and am now thinking they should have...
L. answers from Evansville on August 05, 2009
My 13 month old had a UTI a couple months ago. She had the high fever, but no other symptom I could see. They ran blood tests, and cultures..then a urine sample. Gave a nasty antibiotic that I had to have changed and also an Ultrasound. They say it's common procedure when they are this young just to make sure it isn't a physical problem causing the UTI. I was surprised by all this too.
D.G. answers from Columbus on August 06, 2009
It sounds to me like the Dr. is trying to make more money for the hospital by running Unnecessary tests. If the fever is gone and your daughter is not showing any signs of illness I certainly wouldn't put the child through any more tests.You must have great insurance so they sound like they want to suck it dry.
You might want to concider a second opinion but that can be costly as well. You can't fix what isn't broken and if your daughter seems fine I sure would not run more tests.I do think I would look for a different Ped. though.
P.A. answers from Youngstown on August 06, 2009
Your daughter needs to have the VCUG to check for vericoureteral reflux, a condition where the urine goes back from the bladder through the ureters to the kidneys during urination. Infections and the pressure from the reflux can damage the kidneys. It's more common in girls. Luckily, most kids with it outgrow it. My daughter was 4 when she was diagnosed, and ended up having surgery to correct it just before her 9th birthday. I was concerned about the amount of radiation she was exposed to, as mentioned in another post, as she had the test about 5 times over the years. Our pediatric urologist said that she was exposed to lower doses at the pediatric hospital compared to the tests in the regular hospital. He also said that infections due to wiping (in older kids' cases) are not as common as believed by the general public. I did not get a second opinion. We started off being referred to a regular urologist by our family doctor (no pediatric urologists in our town). I didn't want to do the VCUG and just went with the sonogram, and the doctor actually called and yelled at me about how sometimes parents have to make hard choices to protect their kids, and went over the potential problems down the road if it turned out to be reflux and wasn't treated. I finally went ahead with the test and of course she had it. Later I switched to a pediatric urologist about an hour away in Cleveland cause I didn't like the regular urologist...plus the one we saw in Cleveland chaired the panel that wrote the guidelines for handling reflux in kids. Pediatric hospitals are great for giving the test as well. It was just plain horrible at the regular hospital the first time she had her VCUG. The test is no picnic, but they gave her Versed the first time at the pediatric hospital, after that the child life specialists helped her with coping skills and it went fine. Good luck! If you have any questions let me know.