Occult Infection and Urinary Tract Infection

Infants with serious occult infections may have few or nonspecific symptoms, such as irritability. Some of the most serious infections, such as meningitis and septic arthritis, are addressed in other chapters. Although not as immediately life or limb threatening, urinary tract infections (UTIs) may be responsible for irritability in infants. UTIs develop in approximately 1 % of infants, with premature infants at even higher risk. Because many UTIs are associated with structural urinary tract abnormalities, it is important to diagnose these before permanent renal damage ensues.

Causes

• Urinary tract infection (UTI) is commonly caused by bacteria from the gastrointestinal tract.
• Several organisms that may cause UTI such as includes Escherichia coli, Staphylococcus saprophyticus, Proteus mirabilis.
• Several conditions that may increased risk for developing a UTI such as includes Anatomical problems, Urine retention, Vesicoureteral reflux, Kidney stones, Bladder catheterization, Spinal cord injuries.

Symptoms

• Crying
• Irritability
• Poor feeding

Signs

• Fever ++; occasionally present
• Lethargy
• Vomiting
• Jaundice

Treatment

Prehospital care provided by emergency medical technicians (EMTs) and paramedics may vary from region to region on the basis of regional differences in education, training, and transport times.

• Children with fever alone may require no specific intervention in the EMS setting, except for those other conditions that exist in the presence of fever.
• Assessment of and attention to airway, breathing, and circulation is recommended first for all ill children.
• Those children who have very high fever may become dehydrated, and assessment of the hydration status is indicated.
• Some children may be prone to febrile seizures and seizure precautions should be followed in those with a history of febrile seizures.