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TABLE 3

Features That May Be Helpful in Differentiating Cystitis From APN

CharacteristicAPNUncomplicated 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 clots131,132  
 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 
CharacteristicAPNUncomplicated 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 clots131,132  
 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.

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