Which physical exam findings are associated with pediatric urinary tract infection (UTI)?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Infants and younger children with pyelonephritis usually have no localizing findings, but they are febrile and often irritable. Older children with pyelonephritis often have tenderness of the flank or costovertebral angle, and those with cystitis may have suprapubic tenderness. Hypertension should raise suspicion of hydronephrosis or renal parenchyma disease.

Physical examination findings in pediatric patients with UTI can be summarized as follows:

  • Costovertebral angle tenderness

  • Abdominal tenderness to palpation

  • Suprapubic tenderness to palpation

  • Palpable bladder

  • Dribbling, poor stream, or straining to void

Examine the external genitalia for signs of irritation, pinworms, vaginitis, trauma, or sexual abuse.

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