Contents
What is cystitis?
“Cystitis is inflammation of the bladder. This can have various causes (allergic, toxic…), but when it is caused by bacteria, it is a urinary infection. It is more common in young girls because the duct that leads urine from the bladder to the skin is shorter than in boys. Bacteria can multiply more easily in the urethra – even if this is not the primary cause of the infection which results from poor downward circulation of urine, ”explains Dr Edwige Antier.
How the urinary tract works to understand cystitis
“The urine is filtered by both kidneys, it flows into the small pelvis which collect it and then empty through the two ureters, it then goes down to the bladder which gradually fills up. Two small valves between the ureters and the bladder prevent urine from flowing back up. At the level of the perineum, the bladder is closed by a sphincter, which allows us to be continents until the moment we feel that the bladder is full to open it. The urine then flows into the urethra and empties at the chosen location, ”explains Dr. Antier.
” But sometimes, there are small abnormalities along these urinary tracts that cause urine to stagnate. For example, it could be a poor closing of the valves that let urine flow back up the ureter, or a narrowing along a ureter that causes it to dilate. As with poorly drained water, bacteria multiply. It’s urinary tract infection, ”continues Dr Edwige Antier.
What are the symptoms of cystitis in young girls?
In the baby
- Fever: any temperature above 38 ° C in a baby less than 3 months old requires an examination in the pediatric emergency room to look for the cause, including the urinary tract infection.
- If in addition to the fever, the baby is shivering, is pale and looks dejected: it is also necessary to consult urgently.
- As soon as paracetamol brings the temperature below 38,5 ° C, and if the baby plays, feeds, does not have a rash: “We say that the fever is isolated. The 3-day rule is then applied, the time taken for most viral infections to heal on their own. But if the fever persists, a medical assessment is required, including the search for a urinary tract infection, ”explains the pediatrician.
In children
Must be distinguished :
- Burning sensation when urinating, the urge to urinate often.
- Itching and tingling unrelated to urination, which is more of a sign of “vulvitis”.
How to confirm the diagnosis of cystitis?
- By screening with a test strip: all you have to do is let baby pee in his diaper and soak the test strip in a few drops of urine. If the color indicates the presence of leukocytes and nitrites, it is a sign of infection. It will be necessary to go to the laboratory to complete the diagnosis.
- By the so-called “cytobacteriological” urine examination during which the following are sought:
- cells (cyto): there are many white blood cells to fight against microbes,
- bacteria, their number to tell whether it is an infection or passing bacteria. Their sensitivity to different antibiotics is tested to guide treatment.
- In infants or when the infection is accompanied by fever, a blood test to check that the infection does not go beyond the urinary tract with a risk of serious complications.
What is an ECBU, or cytobacteriological urine test?
The ECBU is the reference tool for diagnosing cystitis. The ECBU, or cytobacteriological examination of the urine, looks for the presence of germs in the urine. In the absence of infection, urine is a sterile medium. If the ECBU detects germs, there is a urinary tract infection. The laboratory then performs an antibiogram to determine which antibiotic will be the most effective in treating the infection.
Collecting urine to diagnose cystitis
Simple in older children who can urinate in the laboratory after a local toilet, the sterile collection of urine is complex in the baby. Placing a bag does not guarantee that the urine will not be contaminated. We often have recourse to a small survey, easier in the girl.
How to treat cystitis?
The doctor will prescribe an antibiotic to treat the cystitis in the little girl as quickly as possible. “Antibiotic treatment is essential: intramuscularly or venously in infants when it comes to an urgent and generalized infection, orally in children without general signs. The choice of antibiotic, the dose and the duration of treatment are adapted to the results of the laboratory. Only the doctor can determine which antibiotic will work.
How to prevent the occurrence of cystitis in babies and little girls?
By gestures of good daily hygiene:
- regularly change her baby’s diaper,
- teach the little girl to wash well,
- teach him to always wipe from front to back after peeing,
- drink regularly.
What is pyelonephritis
Upper urinary tract infection, which is located in a kidney and its ureter, acute pyelonephritis is often the complication of untreated cystitis. It usually manifests as a high fever and fatigue. As with cystitis, this bacterial infection requires antibiotic treatment prescribed by the doctor and rapid support. It is advisable to consult a doctor as soon as the symptoms described above for cystitis appear. In older children, they can take the form of:
- frequent urination and burning sensations
- lower back pain
- cloudy and smelly urine
Once the results of the ECBU are obtained and the antibiotic treatment started, a kidney ultrasound can be done in the days following the infection to avoid complications. Also in a baby, in case of high fever, it is necessary to consult and do the analyzes without delay.
Le Doctor Edwige Antier, pediatrician, is the author of the book “My child in full health, from 0 to 6 years”, with Marie Dewavrin, under the direction of Anne Ghesquière, ed. Eyrolles.