Urinary Tract Infection (Pediatric) Initial Assessment

Last updated: 30 August 2026
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Clinical Presentation

Signs and Symptoms Consistent with Urinary Tract Infection (UTI) Based on Patient’s Age

Infants' <3 Months

Nonspecific signs and symptoms in infants include fever, feeding difficulties, vomiting, lethargy, irritability, and failure to thrive. Less common signs and symptoms include abdominal pain, jaundice, hematuria, strong-smelling urine, sepsis syndrome, and shock.

Toddlers and Preschoolers

Signs and symptoms in toddlers and preschoolers include unusual odor of urine, abdominal or flank pain, frequency, dysuria, and urgency. Nonspecific signs may be present.

School Age

Classical symptoms more common in school age are fever, frequency, urgency, and dysuria. Strong-smelling urine, new-onset urinary incontinence, and changed behavior and abdominal or flank pain may also be present.

Consider UTI in all seriously ill children even when there is evidence of infection outside the urinary tract.

Signs and Symptoms Consistent with Urinary Tract Infection (UTI) Based on Severity

Simple/Mild Urinary Tract Infection (UTI)

A simple urinary tract infection may have mild pyrexia, good fluid intake, and mild dehydration, with good treatment compliance.

Severe Urinary Tract Infection (UTI)

Severe urinary tract infection may have fever (temperature of 39°C), persistent vomiting, and severe dehydration, with poor treatment compliance.



Urinary Tract Infection Pediatric_Initial AssesmentUrinary Tract Infection Pediatric_Initial Assesment

History

Inquire about symptoms of urinary tract infection, such as fever and nonspecific symptoms. Ask about any previous history of urinary tract infections and associated bowel (eg constipation, withholding behaviors) and bladder (eg incontinence, ineffective bladder emptying [eg dribbling, prolonged voiding intervals]) dysfunction. For adolescents, ask about sexual activity. Determine whether the child has had recent antibiotic use and assess for underlying conditions (eg diabetes mellitus [DM] or immunosuppression).

Physical Examination

Assess the vital signs, particularly the temperature and blood pressure (BP). Assess growth parameters, particularly for signs of failure to thrive in infants and younger children, which may indicate chronic or recurrent UTIs. Examine the abdomen for suprapubic tenderness, a distended bladder, abdominal distention, and costovertebral angle tenderness. Examine the genitalia and the presence of vaginal discharge.