For several days, the parents of the 6-month-old girl I'll call Amber dutifully gave her the antibiotics that had been prescribed for her ear infection. But Amber didn't get better. She still had a fever, didn't eat much, and became listless. Her parents brought her to our emergency room at UMass Memorial Medical Center, in Worcester, where tests showed that this little girl was severely dehydrated, with a rapid heartbeat and low blood pressure -- signs of life-threatening septic shock.
Luckily, the doctors were fairly certain what was wrong. One physician inserted a thin plastic tube through Amber's urethra and into her bladder to collect a teaspoon of urine, which was abnormally cloudy. The lab soon confirmed the diagnosis: Amber had a urinary tract infection, or UTI.
UTIs are the most common serious bacterial infection in young children. They're caused by bacteria that climb through the body's plumbing system into the bladder and then up to the kidneys, and they're found in almost one in ten female infants and one in 30 male infants with a high fever. The infections often become serious because babies aren't able to tell anyone about the early mild symptoms like burning or painful urination. Today, pediatricians know it's critical to check the urine of babies and toddlers who have a high fever because otherwise they could miss the problem. Studies show that almost 4 percent of infants who were previously thought to have a fever from another illness such as an ear or a gastrointestinal infection had a UTI (it's possible they had both). When not treated promptly, bacteria can multiply and enter the bloodstream. From there, a UTI can permanently scar the kidneys, which can lead to high blood pressure and other long-term problems. And as with Amber, it can lead to life-threatening complications.