What are the signs that should alert?
Mainly pain when urinating: the child complains of pain and may be afraid to go to the bathroom because of this. His cravings are also more frequent and the urine may be smelly. Another clue: leaks in a child who was clean before. All this can possibly be accompanied by a moderate fever (38.5 ° C on average).
What should you be vigilant about?
We must not confuse the cystitis(bothersome but not serious) with pyelonephritis, an infection that can damage the kidney. What should alert in the latter case is a sudden and high fever (which can reach 39-40 ° C), often without other associated symptoms. At this time, it is necessary to consult without delay to set up the appropriate treatment, especially in an infant.
How do you know there is an infection?
In most cases, a urine dipstick, which is placed directly in contact with urine, is a good revealer. If the result is negative, it is very unlikely that there is an infection. If it is positive, it should be confirmed by a urinalysis (ECBU). In babies, we disinfect locally and put an adhesive bag to collect urine. It is best to take this sample in a laboratory to ensure that the hygienic conditions are optimal.
How is common cystitis treated?
Quite simply by treatment antibiotic, lasting 5 to 7 days. There is no “minute” treatment (single dose of antibiotic) for children as it does for adults.
What are the preventive measures?
It is necessary to insist on hydration and to make him drink water regularly during the day. Then you have to get the child to change his behavior. Make sure it does not hold back: bacteria multiply in the bladder if you wait too long. Also make sure that he empties his bladder completely when he goes to the toilet, several times a day. The ideal is to pee 4 to 6 times a day, or approximately every 3 hours. Finally, think about preventing the constipation, which is a contributing factor.
What to do in the event of a recurrence?
The common urinary tract infection (cystitis) is exceptionally linked to a malformation, but from the third episode, it is necessary to perform an ultrasound to eliminate this track. Most often, it is a problem with voiding behavior. Simple methods of rehabilitation with a pediatrician urologist are enough to restore good habits. But the child must be cooperative: before 6 or 7 years, it is more difficult.
Is it rather a “girl’s disease”?
Yes, for anatomical reasons. The germs that contaminate the bladder come from the perineum. The distance between the bladder and the perineum being shorter, contamination occurs more easily. The child must therefore take the time to pee. He is taught to wipe himself well from front to back: from the urethra to the anus and not the other way around, so as not to transmit germs to the vulvar area. And to sit fearlessly on the toilet. Contrary to popular belief, you do not catch bacteria by sitting on the toilet seat.
Thanks to Prof. Philippe Ravasse, pediatric urological surgeon at the Caen University Hospital.
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