Your child’s stinky urine may be more than just unpleasant: A new study suggests kids with terrible smelling urine should be checked for a urinary tract infection.
According to researchers, only a handful of studies have looked at stinky urine and whether it was a symptom of a urinary tract infection (UTI), but the results were mixed.
“I didn’t believe it was that reliable,” said Dr. Marie Gauthier, the study’s lead author from CHU Sainte-Justine in Montreal.
According to the results of Gauthier’s study, it may not be.
The new study is based on 331 children between the ages of one and 36 months, who were suspected of having a UTI and had a urine test at the emergency room between August 2009 and April 2011.
The parents or people who brought the child into the ER filled out a questionnaire about the child’s medical history and questions about what happened over the previous two days, such as if the child took antibiotics and if their urine smelled “offensive” or “stronger than usual.”
Overall, 51 kids – about 15 percent – were diagnosed with a UTI. The parents of about 57 percent of those said their children had stinky urine over the previous two days – enough to show a link.
But, 32 percent of the parents of children who didn’t have UTIs also reported stinky urine.
AMOXICILLIN is one of the most commonly used antibiotics in the world. It belongs to the spectrum of β-lactam antibiotics, and is the drug of choice when it comes to treating bacterial infections, as it is well absorbed even when given orally. Hence, it is used to treat a variety of infections, including infections of the ear, nose throat, skin infections, urinary tract infections, lower respiratory tract infections, gonorrhea and other sexually transmitted infections etc. AMOXICILLIN for sinus infection treatment is also a very well-known use of this drug. Thus, its multipurpose use makes this drug a very popular one among medical practitioners. However, amoxicillin side effects are something that doctors need to be well aware of, so as to prevent them from occurring, as they can be life-threatening at times.
One of the most serious and dangerous of all side effects is anaphylactic reaction. An anaphylactic reaction is defined as a life-threatening type 1 hypersensitivity reaction to a drug which is given internally or orally. Around 1500 patients die yearly due to an anaphylactic reaction in the United States. However, this serious allergic response of the body only occurs in those patients that have a true allergy to penicillin and its derivatives, as opposed to people who present with pseudo-anaphylaxis or an anaphylactoid reaction. An anaphylactic reaction is characterized by the following signs and symptoms:
– Normally, a true anaphylactic reaction with systemic signs and symptoms begin showing within 72 hours of exposure to the allergen, without the need of further exposure. Skin involvement is one of the first signs seen. This includes generalized hives, skin rashes, itchiness, flushing. Fever is often experienced by people, along with the skin rashes.
– Swelling of lips, tongue and/or throat is also seen, as this is the body’s way of responding and fighting the inflammation.
– Respiratory distress, in the form of difficulty in breathing, shortness of breath, wheezing etc. may also be seen.
– Some patients may also complain of gastrointestinal problems like severe abdominal cramps, stomach pain, diarrhea etc.
– Other serious effects that may occur if immediate action is not taken to deal with the symptoms includes coronary artery spasms, which may lead to myocardial infarction. Consequently, there may also be a sudden drop in blood pressure, which may lead to lightheadedness and fatigue, along with loss of consciousness.
“It is associated with a urine infection, but the association isn’t that strong,” Gauthier told Reuters Health. “To have stinky urine in itself isn’t proof of urine infection. Not at all.”
The researchers write in the journal Pediatrics it could still be useful for doctors and nurses to ask about a child’s urine odor if they suspect a UTI.
The researchers also found that girls were more likely to have UTIs, as were kids who suffered from a condition in which urine flowed backward from their bladder into their upper urinary tract.
Even after accounting for those kids, the researchers said stinky urine was still linked to being diagnosed with a UTI.
While the study could not say why the urine of those with a UTI was stinky, the researchers write that it might be from bacteria.
As for the stinky urine of children without a UTI, Gauthier said it could be from dehydrated kids whose urine is concentrated even though they did not find a link between the two.
WATCH OUT FOR A FEVER
The researchers note that their study did have some limitations. Specifically, the presence of stinky urine was reported by the parents and “offensive” or “stronger” smells may mean different things to different people. The number of kids with a UTI was also small, and the study lacked a control group.
Dr. Nader Shaikh, a professor in the department of pediatrics at University of Pittsburgh School of Medicine in Pennsylvania, told Reuters Health that parents should watch if their children have a fever.
“The main thing to watch out for is a fever. That can be the only sign of a urinary tract infection,” said Shaikh, who was not involved with the new study. He added that children with stinky urine should also be checked.
As Gauthier pointed out, although they determined the evidence is not strong enough to use urine smell as a way to diagnose UTIs, “If the urine is stinky, the risk of having a urine infection is a little bit higher.”
SOURCE: Pediatrics, online April 2, 2012
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Association of Malodorous Urine With Urinary Tract Infection in Children Aged 1 to 36 Months
RESULTS: Three hundred ninety-six children were initially enrolled, but 65 were excluded a posteriori either because a urine culture, although prescribed, was not done (11), was collected by bag (39), and/or showed gross contamination (25). Therefore, 331 children were included in the final analysis. Their median age was 12 months (range, 1–36). Criteria for UTI were fulfilled in 51 (15%). A malodorous urine was reported by parents in 57% of children with UTI and in 32% of children without UTI. On logistic regression, malodorous urine was associated with UTI (odds ratio 2.83, 95% confidence interval: 1.54–5.20). This association remained statistically significant when adjusted for gender and the presence of vesicoureteral reflux (odds ratio 2.73, 95% confidence interval: 1.46–5.08).
CONCLUSIONS: Parental reporting of malodorous urine increases the probability of UTI among young children being evaluated for suspected UTI. However, this association is not strong enough to definitely rule in or out a diagnosis of UTI.
Marie Gauthier, MD,
Serge Gouin, MD,
Ve’ronique Phan, MD, MSc, and
Jocelyn Gravel, MD, MSc
