Acute hemorrhagic cystitis due to Escherichia coli

Acute hemorrhagic cystitis in children has been associated with adenovirus type 11 infection as well as with urinary tract infection due to Escherichia coli. In the United States, the incidence of hemorrhagic cystitis due to E. coli appears to be as high as, or higher than that due to adenovirus type 11, but few studies are available. We studied 14 episodes of acute hemorrhagic cystitis in 13 children aged 2-14 years (mean 6.2). Ten were female. Gross hematuria lasted 1-9 days (mean 2.2). Urine cultures were positive (greater than 10(5) colonies/ml) in 6 episodes (43%). One additional patient had a suspected infection. All children grew E. coli. Pyuria was present in 78.5% but did not correlate with positive cultures. IVP was normal in 82%. E. coli appears to be a much more common cause of acute hemorrhagic cystitis in children than heretofore reported.