E) Viral urinary tract infection (UTI) can be suspected in patients with typical UTI symptoms, hematuria, but negative urine culture
Common causes of gross hematuria in children include UTIs, trauma, and local GU irritation. Nephrolithiasis is less common than in adults, but not exceedingly rare. Initial bleeding (beginning of urinary stream) suggests a urethral source, bleeding throughout the stream suggests kidney, ureter, or bladder source, and terminal bleeding suggests a bladder source. Glomerular disease is associated with brown (tea or cola-colored) urine. Post-strep glomerulonephritis is a common glomerular cause; check for a recent history of pharyngitis or impetigo (in last 2-3 weeks). The “nutcracker syndrome,” compression of the left renal vein by arteries (typically the aorta and supererior mesenteric artery), is a rare cause of pediatric hematuria. Adenovirus can cause a hemorrhagic cystitis; urine culture will not demonstrate a bacterial cause.
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March 15, 2023 at 11:57 am
E) Viral urinary tract infection (UTI) can be suspected in patients with typical UTI symptoms, hematuria, but negative urine culture
Common causes of gross hematuria in children include UTIs, trauma, and local GU irritation. Nephrolithiasis is less common than in adults, but not exceedingly rare. Initial bleeding (beginning of urinary stream) suggests a urethral source, bleeding throughout the stream suggests kidney, ureter, or bladder source, and terminal bleeding suggests a bladder source. Glomerular disease is associated with brown (tea or cola-colored) urine. Post-strep glomerulonephritis is a common glomerular cause; check for a recent history of pharyngitis or impetigo (in last 2-3 weeks). The “nutcracker syndrome,” compression of the left renal vein by arteries (typically the aorta and supererior mesenteric artery), is a rare cause of pediatric hematuria. Adenovirus can cause a hemorrhagic cystitis; urine culture will not demonstrate a bacterial cause.