American Academy of Pediatrics

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TABLE 3

Features That May Be Helpful in Differentiating Cystitis From APN

Characteristic	APN	Uncomplicated Cystitis
Age distribution	More common in younger children	Typically in children aged >2 y
Fever¹³⁰	>38°C	Afebrile or low-grade fever ≤38°C
Recent viral illness¹³¹	NA	Viral cystitis
Systemic symptoms	Common	Uncommon
Local symptoms	Flank pain and/or tenderness	Dysuria, urgency, frequency, urinary incontinence, suprapubic pain, and/or hematuria
Causative agent	Bacterial (E coli is the commonest)	Bacterial (E coli is the commonest), viral, fungal, and chemical
Urinary findings
Gross hematuria	Uncommon	May have fresh blood and clots^131,132
Urine culture for bacteria	Positive	Negative results in viral, fungal, and chemical cystitis
RBUS	Normal or may reveal edema and hyperemia of kidney	Normal or may reveal thickened urinary bladder wall, debris in the bladder
Renal complication	Renal scarring	None

Characteristic	APN	Uncomplicated Cystitis
Age distribution	More common in younger children	Typically in children aged >2 y
Fever¹³⁰	>38°C	Afebrile or low-grade fever ≤38°C
Recent viral illness¹³¹	NA	Viral cystitis
Systemic symptoms	Common	Uncommon
Local symptoms	Flank pain and/or tenderness	Dysuria, urgency, frequency, urinary incontinence, suprapubic pain, and/or hematuria
Causative agent	Bacterial (E coli is the commonest)	Bacterial (E coli is the commonest), viral, fungal, and chemical
Urinary findings
Gross hematuria	Uncommon	May have fresh blood and clots^131,132
Urine culture for bacteria	Positive	Negative results in viral, fungal, and chemical cystitis
RBUS	Normal or may reveal edema and hyperemia of kidney	Normal or may reveal thickened urinary bladder wall, debris in the bladder
Renal complication	Renal scarring	None

NA, not applicable.