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Dysuria in Children

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501. Toxicity, Marine - Ciguatera (Diagnosis)

Painful paresthesias of the extremities Paradoxical temperature reversal (eg, cold objects feel hot and hot objects feel cold; classic symptom) Dental pain (teeth feel loose) Pruritus Arthralgias Myalgias Weakness Ataxia, vertigo Respiratory paralysis Coma In children, irritability may be the only presenting neurologic symptom. Cardiovascular findings may reflect the following: Bradycardia Hypotension Pulmonary edema Other general symptoms include the following: Dysuria Chills Sweating Painful (...) , Harvard Medical School Dana A Stearns, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center Disclosure: Merck Salary Employment John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals John T VanDeVoort, PharmD is a member of the following medical

2014 eMedicine Pediatrics

502. Urinary Tract Infection (Diagnosis)

Poor feeding Vomiting Irritability Infants and children aged 2 months to 2 years Infants with UTI may display the following symptoms: Poor feeding Fever Vomiting Strong-smelling urine Abdominal pain Irritability Children aged 2-6 years Preschoolers with UTI can display the following symptoms: Vomiting Abdominal pain Fever Strong-smelling urine Enuresis Urinary symptoms (dysuria, urgency, frequency) Children older than 6 years and adolescents School-aged children with UTI can display the following (...) . Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J . 2008 Apr. 27(4):302-8. . Hoberman A, Chao HP, Keller DM, Hickey R, Davis HW, Ellis D. Prevalence of urinary tract infection in febrile infants. J Pediatr . 1993 Jul. 123(1):17-23. . Downs SM. Technical report: urinary tract infections in febrile infants and young children. The Urinary Tract Subcommittee of the American Academy of Pediatrics Committee on Quality Improvement. Pediatrics . 1999 Apr. 103(4):e54

2014 eMedicine Pediatrics

503. Urinary Tract Infection (Treatment)

kidney disease in children. Pediatr Nephrol . 2012 Mar. 27(3):363-73. . . Zorc JJ, Levine DA, Platt SL, Dayan PS, Macias CG, Krief W, et al. Clinical and demographic factors associated with urinary tract infection in young febrile infants. Pediatrics . 2005 Sep. 116(3):644-8. . Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F, et al. Does this child have a urinary tract infection?. JAMA . 2007 Dec 26. 298(24):2895-904. . [Guideline] Committee on Quality Improvement, Subcommittee (...) renal scarring and that this renal scarring was significantly associated with a delay in the initiation of antimicrobial therapy. [ , ] According to AAP guidelines for the treatment of initial UTIs in febrile infants and children aged 2-24 months old, antibiotics can be given orally or parenterally, with the choice of route based on practical considerations. [ ] Oral antibiotics should not be used in a child who is acutely ill or toxic, has persistent vomiting, or has moderate to severe dehydration

2014 eMedicine Pediatrics

504. Toxicity, Seafood (Treatment)

, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center Disclosure: Received salary from Merck for employment. Chief Editor Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin Timothy E Corden, MD is a member of the following medical societies (...) resolve within 24 hours, although a late-presenting and extended course is not uncommon. GI symptoms generally consist of diaphoresis, abdominal cramps, nausea, vomiting, profuse watery diarrhea, and dysuria. GI symptoms are usually reported to occur prior to neurological symptoms. Interesting, however, is that the predominance of GI or neurologic symptoms seems to vary according to regions, with GI-predominant illness seen in the Caribbean, while neurologic symptoms predominate in the Indo-Pacific

2014 eMedicine Pediatrics

505. Somatoform Disorder: Somatization (Treatment)

medical outpatient visits. [ ] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [ ] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms. Somatization in children consists of the persistent experience (...) is the major factor in the pain symptom. [ ] Recurrent abdominal pain (RAP) is the most common recurrent pain complaint of childhood. RAP has been defined by intermittent pain with full recovery between episodes lasting more than 3 months. [ ] Epidemiological studies suggest that RAP effects 8-25% of school-age children aged 9-12 years, is more prevalent among girls, and accounts for 2-4% of pediatric office visits. [ ] An estimated 10% of these patients have documented physical illness, with one third

2014 eMedicine Pediatrics

506. Toxicity, Seafood (Overview)

, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center Disclosure: Received salary from Merck for employment. Chief Editor Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin Timothy E Corden, MD is a member of the following medical societies (...) resolve within 24 hours, although a late-presenting and extended course is not uncommon. GI symptoms generally consist of diaphoresis, abdominal cramps, nausea, vomiting, profuse watery diarrhea, and dysuria. GI symptoms are usually reported to occur prior to neurological symptoms. Interesting, however, is that the predominance of GI or neurologic symptoms seems to vary according to regions, with GI-predominant illness seen in the Caribbean, while neurologic symptoms predominate in the Indo-Pacific

2014 eMedicine Pediatrics

507. Somatoform Disorder: Somatization (Diagnosis)

medical outpatient visits. [ ] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [ ] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms. Somatization in children consists of the persistent experience (...) is the major factor in the pain symptom. [ ] Recurrent abdominal pain (RAP) is the most common recurrent pain complaint of childhood. RAP has been defined by intermittent pain with full recovery between episodes lasting more than 3 months. [ ] Epidemiological studies suggest that RAP effects 8-25% of school-age children aged 9-12 years, is more prevalent among girls, and accounts for 2-4% of pediatric office visits. [ ] An estimated 10% of these patients have documented physical illness, with one third

2014 eMedicine Pediatrics

508. Menstruation Disorders (Diagnosis)

, Roche AF, Kulin HE, Lee PA, Himes JH, et al. Age at menarche and racial comparisons in US girls. Pediatrics . 2003 Jan. 111(1):110-3. . Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child . 1969 Jun. 44(235):291-303. . . World Health Organization multicenter study on menstrual and ovulatory patterns in adolescent girls. II. Longitudinal study of menstrual patterns in the early postmenarcheal period, duration of bleeding episodes and menstrual cycles. World (...) of inherited bleeding disorders in women with menorrhagia. Lancet . 1998 Feb 14. 351(9101):485-9. . Ragni MV, Bontempo FA, Hassett AC. von Willebrand disease and bleeding in women. Haemophilia . 1999 Sep. 5(5):313-7. . Werner EJ, Broxson EH, Tucker EL, Giroux DS, Shults J, Abshire TC. Prevalence of von Willebrand disease in children: a multiethnic study. J Pediatr . 1993 Dec. 123(6):893-8. . Shankar M, Lee CA, Sabin CA, Economides DL, Kadir RA. von Willebrand disease in women with menorrhagia: a systematic

2014 eMedicine Pediatrics

509. Hypercalciuria (Treatment)

al. Prevalence and spot urine risk factors for renal stones in children taking topiramate. J Pediatr Urol . 2013 Jan 31. . . Vachvanichsanong P, Malagon M, Moore ES. Recurrent abdominal and flank pain in children with idiopathic hypercalciuria. Acta Paediatr . 2001 Jun. 90(6):643-8. . Alon US, Berenbom A. Idiopathic hypercalciuria of childhood: 4- to 11-year outcome. Pediatr Nephrol . 2000 Sep. 14(10-11):1011-5. . Escribano J, Balaguer A, Martin R, Feliu A, Espax R. Childhood idiopathic (...) degree of hematuria and back or abdominal pain and is also sometimes associated with voiding symptoms. Microcrystallization of calcium with urinary anions has been suggested to lead to injury of the uroepithelium in children with hypercalciuria. Consequently, when taking the history of the illness, attempt to identify symptoms relating to the urinary tract, paying special attention to the following signs and symptoms: Dysuria Abdominal pain Irritability (infants) Urinary frequency Urinary urgency

2014 eMedicine Pediatrics

510. Hematopoietic Stem Cell Transplantation (Treatment)

hampered by small numbers. [ ] Patients treated with chemotherapy alone have achieved remission, but overall survival has been poor. [ , ] In a comparison allogeneic transplant versus chemotherapy in children with Phl + ALL (UK Medical Research Council trial for childhood ALL [MRC ALL 97] program from 1997-2002), 3-year survival was reported as 60% compared with 36%, respectively. [ ] Children with induction failure (M2 or M3 bone marrow status at the end of 1 mo of therapy) were found to have very (...) Leukocyte adhesion deficiency Indications for HSCT in specific diseases Acute myeloid leukemia Allogeneic HSCT is the treatment of choice for all children with acute myeloid leukemia (AML) with a human leukocyte antigen (HLA) ̶ matched sibling in their first complete remission (CR1). In adults, this is reserved for those with high-risk features in their CR1. In adults with standard or good risk features, stem cell transplantation is reserved for their second complete remission (CR2). HSCT is the only

2014 eMedicine Pediatrics

511. Hypercalciuria (Overview)

al. Prevalence and spot urine risk factors for renal stones in children taking topiramate. J Pediatr Urol . 2013 Jan 31. . . Vachvanichsanong P, Malagon M, Moore ES. Recurrent abdominal and flank pain in children with idiopathic hypercalciuria. Acta Paediatr . 2001 Jun. 90(6):643-8. . Alon US, Berenbom A. Idiopathic hypercalciuria of childhood: 4- to 11-year outcome. Pediatr Nephrol . 2000 Sep. 14(10-11):1011-5. . Escribano J, Balaguer A, Martin R, Feliu A, Espax R. Childhood idiopathic (...) degree of hematuria and back or abdominal pain and is also sometimes associated with voiding symptoms. Microcrystallization of calcium with urinary anions has been suggested to lead to injury of the uroepithelium in children with hypercalciuria. Consequently, when taking the history of the illness, attempt to identify symptoms relating to the urinary tract, paying special attention to the following signs and symptoms: Dysuria Abdominal pain Irritability (infants) Urinary frequency Urinary urgency

2014 eMedicine Pediatrics

512. Herpes Simplex Virus Infection (Overview)

> Pediatric Herpes Simplex Virus Infection Updated: Feb 27, 2019 Author: J Michael Klatte, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Pediatric Herpes Simplex Virus Infection Overview Practice Essentials Herpes simplex virus (HSV) infections are ubiquitous and have a wide range of clinical manifestations (see the images below). Beyond the neonatal period, most primary HSV-1 infections occur in infancy and childhood and are transmitted primarily by contact (...) , most primary HSV-1 infections occur in infancy and childhood and are transmitted primarily by contact with infected saliva. Primary HSV-2 infections are acquired after onset of sexual activity and genital herpes infections are among the most common sexually transmitted infections (STIs). The prevalence of herpes simplex virus infections depends on socioeconomic status, age, race, and geographic location. For example, approximately 33% of children from lower socioeconomic backgrounds have serologic

2014 eMedicine Pediatrics

513. Hematopoietic Stem Cell Transplantation (Overview)

hampered by small numbers. [ ] Patients treated with chemotherapy alone have achieved remission, but overall survival has been poor. [ , ] In a comparison allogeneic transplant versus chemotherapy in children with Phl + ALL (UK Medical Research Council trial for childhood ALL [MRC ALL 97] program from 1997-2002), 3-year survival was reported as 60% compared with 36%, respectively. [ ] Children with induction failure (M2 or M3 bone marrow status at the end of 1 mo of therapy) were found to have very (...) Leukocyte adhesion deficiency Indications for HSCT in specific diseases Acute myeloid leukemia Allogeneic HSCT is the treatment of choice for all children with acute myeloid leukemia (AML) with a human leukocyte antigen (HLA) ̶ matched sibling in their first complete remission (CR1). In adults, this is reserved for those with high-risk features in their CR1. In adults with standard or good risk features, stem cell transplantation is reserved for their second complete remission (CR2). HSCT is the only

2014 eMedicine Pediatrics

514. Arthritis, Conjunctivitis, Urethritis Syndrome (Overview)

). Rheumatol Int . 2009 Jul. 29(9):1097-9. . Rueda JC, Crepy MF, Mantilla RD. Clinical features of Poncet's disease. From the description of 198 cases found in the literature. Clin Rheumatol . 2013 Jul. 32(7):929-35. . Prati C, Bertolini E, Toussirot E, Wendling D. Reactive arthritis due to Clostridium difficile. Joint Bone Spine . 2010 Mar. 77(2):190-2. . Durand CL, Miller PF. Severe Clostridium difficile colitis and reactive arthritis in a ten-year-old child. Pediatr Infect Dis J . 2009 Aug. 28(8):750-1 (...) findings of enthesitis in reactive arthritis. Clin Nucl Med . 2011 Feb. 36(2):121-3. . Simonini G, Taddio A, Cimaz R. No evidence yet to change American Heart Association recommendations for poststreptococcal reactive arthritis: comment on the article by van Bemmel et al. Arthritis Rheum . 2009 Nov. 60(11):3516-8; author reply 3518-9. . Moorthy LN, Gaur S, Peterson MG, Landa YF, Tandon M, Lehman TJ. Poststreptococcal reactive arthritis in children: a retrospective study. Clin Pediatr (Phila) . 2009 Mar

2014 eMedicine Pediatrics

515. Hematopoietic Stem Cell Transplantation (Diagnosis)

hampered by small numbers. [ ] Patients treated with chemotherapy alone have achieved remission, but overall survival has been poor. [ , ] In a comparison allogeneic transplant versus chemotherapy in children with Phl + ALL (UK Medical Research Council trial for childhood ALL [MRC ALL 97] program from 1997-2002), 3-year survival was reported as 60% compared with 36%, respectively. [ ] Children with induction failure (M2 or M3 bone marrow status at the end of 1 mo of therapy) were found to have very (...) Leukocyte adhesion deficiency Indications for HSCT in specific diseases Acute myeloid leukemia Allogeneic HSCT is the treatment of choice for all children with acute myeloid leukemia (AML) with a human leukocyte antigen (HLA) ̶ matched sibling in their first complete remission (CR1). In adults, this is reserved for those with high-risk features in their CR1. In adults with standard or good risk features, stem cell transplantation is reserved for their second complete remission (CR2). HSCT is the only

2014 eMedicine Pediatrics

516. Herpes Simplex Virus Infection (Diagnosis)

> Pediatric Herpes Simplex Virus Infection Updated: Feb 27, 2019 Author: J Michael Klatte, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Pediatric Herpes Simplex Virus Infection Overview Practice Essentials Herpes simplex virus (HSV) infections are ubiquitous and have a wide range of clinical manifestations (see the images below). Beyond the neonatal period, most primary HSV-1 infections occur in infancy and childhood and are transmitted primarily by contact (...) , most primary HSV-1 infections occur in infancy and childhood and are transmitted primarily by contact with infected saliva. Primary HSV-2 infections are acquired after onset of sexual activity and genital herpes infections are among the most common sexually transmitted infections (STIs). The prevalence of herpes simplex virus infections depends on socioeconomic status, age, race, and geographic location. For example, approximately 33% of children from lower socioeconomic backgrounds have serologic

2014 eMedicine Pediatrics

517. Hematuria (Diagnosis)

Nephrol . 2009 Oct. 24(10):1951-8. . Expert Panel on Pediatric Imaging:., Dillman JR, Rigsby CK, Iyer RS, Alazraki AL, Anupindi SA, et al. ACR Appropriateness Criteria ® Hematuria-Child. J Am Coll Radiol . 2018 May. 15 (5S):S91-S103. . Diven SC, Travis LB. A practical primary care approach to hematuria in children. Pediatr Nephrol . 2000 Jan. 14(1):65-72. . Dodge WF, West EF, Smith EH, Bruce Harvey 3rd. Proteinuria and hematuria in schoolchildren: epidemiology and early natural history. J Pediatr (...) . . Kalia A, Travis LB, Brouhard BH. The association of idiopathic hypercalciuria and asymptomatic gross hematuria in children. J Pediatr . 1981 Nov. 99(5):716-9. . Kincaid-Smith P, Fairley K. The investigation of hematuria. Semin Nephrol . 2005 May. 25(3):127-35. . Krieger I, Sargent DA. A postural sign in the sensory deprivation syndrome in infants. J Pediatr . 1967 Mar. 70(3):332-9. . Loo RK, Lieberman SF, Slezak JM, Landa HM, Mariani AJ, Nicolaisen G, et al. Stratifying risk of urinary tract

2014 eMedicine Pediatrics

518. Hemorrhagic Cystitis (Diagnosis)

stem cell transplantation. Biol Blood Marrow Transplant . 2011 Oct. 17(10):1512-9. . Hatakeyama N, Suzuki N, Yamamoto M, Kuroiwa Y, Hori T, Mizue N, et al. Detection of BK virus and adenovirus in the urine from children after allogeneic stem cell transplantation. Pediatr Infect Dis J . 2006 Jan. 25(1):84-5. . Hoffman JA, Shah AJ, Ross LA, Kapoor N. Adenoviral infections and a prospective trial of cidofovir in pediatric hematopoietic stem cell transplantation. Biol Blood Marrow Transplant . 2001. 7 (...) , Choi Y, et al. Isolation of adenovirus type 7 from the urine of children with acute hemorrhagic cystitis. Pediatr Infect Dis J . 1996 Jul. 15(7):633-4. . Mori T, Aisa Y, Shimizu T, Ikeda Y, Okamoto S, Okada K, et al. Hemorrhagic cystitis caused by adenovirus type 34 after allogeneic bone marrow transplantation. Transplantation . 2005 Mar 15. 79(5):624. . Umekawa T, Kurita T. Acute hemorrhagic cystitis by adenovirus type 11 with and without type 37 after kidney transplantation. Urol Int . 1996. 56(2

2014 eMedicine Pediatrics

519. Gonorrhea (Diagnosis)

partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact in the child's household (...) of reported gonorrhea cases by age group and sex, United States, 2016. Courtesy of the Centers for Disease Control and Prevention (CDC). Infection in children is a marker for child sexual abuse and should be reported as such, although a 2007 review provided some support for nonsexual transmission between children and for transmission from adults to children related to poor hand hygiene. [ , ] Gonococcemia remains an important disease in the adolescent and young adult population, with a peak incidence

2014 eMedicine Pediatrics

520. Acute Abdomen and Pregnancy (Follow-up)

(CT) examination is substantially below this level. [ ] During pregnancy, perform medically indicated diagnostic radiographic procedures when needed; when possible, however, consider other imaging procedures not associated with ionizing radiation instead of radiography. [ ] Because of the possible association of antenatal radiation exposure with childhood cancer, [ ] use ionizing radiation only when medically necessary, and minimize that exposure when possible without compromising patient care (...) for urolithiasis is approximately 1:1600. [ , ] For patient education information, see the , as well as and . History and physical examination Findings in urolithiasis include the following: Pain, usually in the flank - Almost always the presenting complaint Nausea and vomiting Dysuria Urgency Fever Gross hematuria History of a prior episode - In 25% of patients [ , ] Costovertebral angle tenderness - Almost always present Abdominal tenderness - Sometimes observed Workup Patients with urolithiasis may have

2014 eMedicine Surgery

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