Pediatric emergency medicine trisk 1119 1119
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diagnosis requires either identification of the larvae or ova, or a response to a trial
of mebendazole.
Lastly, the provider should give consideration to both sexual abuse and
psychogenic dysuria. In most of these cases, further evaluation outside of the ED
is needed.
SYMPTOMATIC MANAGEMENT
When a specific diagnosis has not been established and the provider is awaiting
the results of cultures, therapy directed at the symptom of dysuria can provide
some relief. Generally, dilute urine causes less irritation than concentrated urine,
so a generous fluid intake is recommended. Warm water sitz baths may be helpful
in the child with urethritis or vulvovaginitis. For the child older than 6 years,
phenazopyridine (Pyridium) at a dosage of 12 mg/kg/day divided into three doses
(daily maximum 600 mg per day), administered for up to 2 days, may be helpful
as a urinary tract anesthetic.
