Important aspects of the examination in child (≥2 years) or adolescent with suspected acute infectious cystitis

Examination finding	Potential significance
Fever (temperature ≥38°C [100.4°F])	May suggest upper UTI
Blood pressure	Hypertension may be an early sign of chronic kidney disease
Growth parameters	Poor weight gain may be an indication of chronic or recurrent UTI
Abdominal palpation	Enlarged bladder or kidney suggestive of anatomic abnormality
Suprapubic or costovertebral angle tenderness	Suprapubic tenderness is suggestive of lower UTI; costovertebral angle tenderness is suggestive of upper UTI
Lower back for signs of occult myelodysplasia (eg, midline pigmentation, lipoma, vascular lesions, sinus, tuft of hair)	May be associated with neurogenic bladder
External genitalia	May reveal anatomic abnormalities that predispose to UTI (eg, phimosis, labial adhesions) or signs of considerations in the differential diagnosis (eg, vulvovaginitis, vaginal foreign body, sexually transmitted infection)

UTI: urinary tract infection.

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