Resolution of VUR - Pediatric Oncall

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Childhood Ailments

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	Specialist Answers
Question
I know you can't give med advice but please help us even if you can tell us were to go to look up info. Our 3 year old daughter had a Kidney reflux. She took septra for 1 year, when she went back to the specialist the reflux had corrected itself. During that year she continued to have red cells and occasional white cells in her urine, the doter said that should stop now that she was off the septra. That was in June of 2001.Since then she has continued to have red cells98% of the time and white cell at least 85% of the time. She will have all the signs of an infection but when the culture is done it shows no infection. She has at times had severe pain almost always has discomfort. She complains of her lower belly hurting and her lower back. Sometimes it hurts so much she doesn't want to let her pee out.then screams when it does. She will tell us that her vagina hurts. They will do a culture and it usually comes back negative for infection even though the dip test in the doctors office shows red and white cells. Cassidy returns to the specialist on May 31 2002. My husband and I would like to check out what we can on the internet or library so that we can go there knowing what questions to ask and be somewhat informed. One specialist suggested a gynecologist but two other doctors said it there was nothing outside what is wrong is internal. We are feeling very confused as well as frustrated for her. Anyway you can help us would be greatly appreciated. Thank you for your time and in advance for your help.
Answer
Since, your child has had resolution of the VUR, reflux seems unlikely. What she seems to have is a cystitis that is infection in the bladder but that would be picked up on a urine culture. Since her urine shows presence of red cells and white cells, you may need to rule out other local infection such as vulvitis and vaginal infection. You may have to show her to the gynecologist for the same. Other condition that may cause this kind of pain and red cells in the urine is "hypercalciuria" or increased calcium loss in the urine. This can be confirmed by a simple urine test where the calcium/creatinine ratio is estimated. Hope this is useful to you. Back to All Questions

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