You are asked to see a six year old boy who has had dysuria (painful urination), urinary frequency and urgency and left flank pain for two days. On exam you find no fever, but tenderness in the suprapubic area and in the left flank. The urinalysis shows 20-30 WBC's per high power field, 10-15 RBC's per high power field and many bacteria.
You prescribe oral antibiotics and by the next day the child feels much better. The mother wants to know why her son has had a urine infection. You should:
Reassure her that many children get urine infections.
Order a renal and bladder ultrasound.
Order a voiding cystourethrogram (VCUG).
Put the child on long-term oral antibiotics.
©David A. Hatch, M.D., 1996