Pediatric emergency medicine trisk 1531 1531
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Frequency is often associated with urinary tract infection (UTI) and as such this
diagnosis should be of high suspicion (see Chapters 31 Fever , 94 Infectious
Disease Emergencies ). Accurate diagnosis of pediatric UTI is important to
ensure both appropriate initial treatment and follow-up evaluation. Viral (e.g.,
adenovirus) or fungal cystitis should be considered in patients with a negative
urine culture, especially those who are immunocompromised. Chemical cystitis
can occur, but is a rare diagnosis in pediatric populations. Partial distal urethral
obstruction, specifically posterior urethral valves, may cause frequency as
patients cannot empty the bladder and instead produce frequent small voids. The
urinary stream in the male child who presents with posterior urethral valves is
usually nonforceful and not sustained and may be associated with straining. The
enlarged bladder is sometimes palpable as a lower abdominal mass.
