{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:38:55Z","timestamp":1787567935977,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Objectives:<\/jats:title>\n Hemorrhagic urinary tract infections (UTIs) are rare among healthy young males, and these infections lack epidemiological data as well as a standardized approach in the emergency department (ED). The purpose of this study was to investigate the presentation of healthy pediatric males presenting to the ED with features associated with hematuria and UTIs.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We performed a retrospective chart review of male patients aged 1 to 8 years presenting to a single pediatric ED from January 2016 to December 2022 with ICD-10 codes related to UTI and hematuria. Demographic and clinical data were collected, and multivariable regressions were performed with subgroup comparisons by gross hematuria and age.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 634 included male patients, 213 (34%) had gross hematuria. These children were older (\n P<\/jats:italic>\n < 0.0001) and had lower rates of confirmed UTI (\n P<\/jats:italic>\n = 0.002). Urine cultures most commonly grew\n Escherichia coli<\/jats:italic>\n and\n Proteus mirabilis<\/jats:italic>\n , with age-specific differences in isolated organisms. Gross hematuria was independently associated with lower odds of UTI after adjustment for age, circumcision status, and presenting symptoms (OR: 0.49, CI: 0.29-0.82;\n P<\/jats:italic>\n = 0.007). In a subgroup analysis of children with gross hematuria, older age (5 to 8\u00a0y) was associated with decreased odds of UTI (OR: 0.77, CI: 0.61-0.97;\n P<\/jats:italic>\n = 0.02).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Within this ICD-defined cohort, gross hematuria was associated with lower odds of confirmed UTI, with odds decreasing with increasing age. These findings suggest that gross hematuria alone may be a poor predictor of UTI and should be interpreted with caution when considering empiric antibiotic treatment, highlighting the importance of antibiotic stewardship in the ED.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000003675","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:00:08Z","timestamp":1787565608000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Analysis of Genitourinary Complaints in Pediatric Males Presenting to the Emergency Department"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6478-8046","authenticated-orcid":false,"given":"Ryan C.","family":"Lovell","sequence":"first","affiliation":[{"name":"School of Medicine, University of California, Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruchira","family":"Puri","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, Riverside"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby K.","family":"Shelton","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Rady Children\u2019's Hospital of Orange County, Orange, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Bacon","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Rady Children\u2019's Hospital of Orange County, Orange, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy C.","family":"Boswell","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Children\u2019s Hospital of Alabama, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Heyming","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Rady Children\u2019's Hospital of Orange County, Orange, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Davis-Dao","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, Irvine"},{"name":"Department of Pediatric Emergency Medicine, Rady Children\u2019's Hospital of Orange County, Orange, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymen R.","family":"Assaf","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Rady Children\u2019's Hospital of Orange County, Orange, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"R1-20260824","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1542\/peds.59.4.557","article-title":"Frequency and etiology of gross hematuria in a general pediatric setting","volume":"59","author":"Ingelfinger","year":"1977","journal-title":"Pediatrics"},{"key":"R2-20260824","doi-asserted-by":"crossref","first-page":"e2020012138","DOI":"10.1542\/peds.2020-012138","article-title":"Contemporary management of urinary tract infection in children","volume":"147","author":"Mattoo","year":"2021","journal-title":"Pediatrics"},{"key":"R3-20260824","doi-asserted-by":"crossref","first-page":"e2444495","DOI":"10.1001\/jamanetworkopen.2024.44495","article-title":"Guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults: a wikiguidelines group consensus statement","volume":"7","author":"Nelson","year":"2024","journal-title":"JAMA Netw Open"},{"key":"R4-20260824","doi-asserted-by":"crossref","first-page":"e2020040295","DOI":"10.1542\/peds.2020-040295","article-title":"Committee on infectious diseases, pediatric infectious diseases society. Antibiotic Stewardship in pediatrics","volume":"147","author":"Gerber","year":"2021","journal-title":"Pediatrics"},{"key":"R5-20260824","doi-asserted-by":"crossref","first-page":"e1251","DOI":"10.1097\/PEC.0000000000002586","article-title":"Predictors of empiric antibiotic use in the emergency department in children without urinary tract infections","volume":"38","author":"Forster","year":"2022","journal-title":"Pediatr Emerg Care"},{"key":"R6-20260824","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1542\/hpeds.2024-007756","article-title":"Antibiotic appropriateness for urinary tract infections in children","volume":"14","author":"Dantas","year":"2024","journal-title":"Hosp Pediatr"},{"key":"R7-20260824","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","year":"2007","journal-title":"Brit Med J"},{"key":"R8-20260824","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/PEC.0000000000002868","article-title":"Opportunities for antibiotic reduction in pediatric patients with urinary tract infection after discharge from the emergency department","volume":"39","author":"Hawkins","year":"2023","journal-title":"Pediatr Emerg Care"},{"key":"R9-20260824","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1002\/jhm.13390","article-title":"Outcomes associated with initial narrow-spectrum versus broad-spectrum antibiotics in children hospitalized with urinary tract infections","volume":"19","author":"Markham","year":"2024","journal-title":"J Hosp Med"},{"key":"R10-20260824","doi-asserted-by":"crossref","first-page":"e20173239","DOI":"10.1542\/peds.2017-3239","article-title":"The diagnosis of UTI: colony count criteria revisited","volume":"141","author":"Roberts","year":"2018","journal-title":"Pediatrics"},{"key":"R11-20260824","doi-asserted-by":"crossref","first-page":"37","DOI":"10.7812\/TPP\/08-083","article-title":"National practice recommendations for hematuria: how to evaluate in the absence of strong evidence?","volume":"13","author":"Loo","year":"2009","journal-title":"Perm J"},{"key":"R12-20260824","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3390\/children11020248","article-title":"Risk factors for urinary tract infections in children with hematuria in the emergency department","volume":"11","author":"Guo","year":"2024","journal-title":"Children"},{"key":"R13-20260824","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1136\/jcp.2009.074617","article-title":"Urinary tract pathogens and resistance pattern","volume":"63","author":"Chakupurakal","year":"2010","journal-title":"J Clin Pathol"},{"key":"R14-20260824","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3390\/pathogens13030201","article-title":"Pathogens causing pediatric community acquired urinary tract infections and their increasing antimicrobial resistance: a nationwide study","volume":"13","author":"Shkalim Zemer","year":"2024","journal-title":"Pathogens"},{"key":"R15-20260824","first-page":"236","article-title":"Urinary tract infection in outpatient children and adolescents: risk analysis of antimicrobial resistance","volume":"22","author":"Eremenko","year":"2020","journal-title":"Isr Med Assoc J IMAJ"},{"key":"R16-20260824","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.juro.2013.01.069","article-title":"Antibiotic resistance patterns of outpatient pediatric urinary tract infections","volume":"190","author":"Edlin","year":"2013","journal-title":"J Urol"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003675","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:00:10Z","timestamp":1787565610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003675"}},"subtitle":["Exploring the Relationship Between Gross Hematuria and Urinary Tract Infections"],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":16,"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003675","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"value":"0749-5161","type":"print"},{"value":"1535-1815","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"assertion":[{"value":"2026-04-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}