Paediatrics – MCQ 28 – A 3-year-old boy presents with fever; dysuria and gross hematuria

A 3-year-old boy presents with fever; dysuria and gross hematuria. Physical examination shows a prominent suprapubic area which is dull on percussion. Urinalysis reveals red blood cells but no proteinuria. Which of the following is the most likely diagnosis?
a) Acute glomerulonephritis
b) Urinary tract infection
c) Posterior urethral valves
d) Teratoma

Correct answer :
c) Posterior urethral valves

Lets analyse the question. There is fever, dysuria and gross hematuria – indicates urinary tract infection. But urinary tract infections are uncommon in boys unless there is some congenital anomaly of the urogenital tract. Physical examination shows a prominent suprapubic area which is dull on percussion – due to enlarged bladder – indicating obstruction below the level of bladder. Posterior urethral valve is the most common cause of obstructive uropathy in a male child.

More info : Posterior urethral valves – Pathology, Clinical features, Diagnosis and Management