In this section
Haematuria is the presence of red blood cells in the urine. The
presence of 10 or more RBCs per high-power field is abnormal.
Urinary dipsticks are very sensitive and can be positive at
<5 RBCs per high-power field.
Red or brown urine does not always indicate haematuria
(haemoglobinuria, myoglobinuria, medication, and food).
Urate crystals are commonly present in the urine of newborn
babies. They can produce a red discolouration of the nappy ("brick
dust" appearance) which is sometimes mistaken for blood.
Blood in the urine may come from sources other than the urinary
tract (eg vaginal haemorrhage, rectal fissure).
Common causes for microhaematuria include in association with
viral infections, UTI, Trauma, HSP.
If you find microscopic haematuria in the setting of an acute
febrile illness, exclude UTI by urine culture and arrange for the
urine to be tested again after the acute illness has passed.
Common causes for macroscopic haematuria include the above. It
is more likely to come from the bladder or urethra.
Symptomless or "Benign Haematuria" in children without growth
failure, hypertension, oedema, proteinuria, urinary casts or renal
impairment is a frequent finding.
In the emergency department it is important in evaluating a
child with haematuria to identify serious, treatable and
Many children with isolated microscopic haematuria require no
immediate investigation and simply need to be checked to see if the
problem persists. This should be arranged with the general
practitioner or through outpatient clinic if the family do not have
Larger view of flowchart