BMJ Case Reports 2012; doi:10.1136/bcr-2012-007831
  • Unusual association of diseases/symptoms

Polyuria and ‘watery wee’ in a toddler

  1. Leonie Perera2
  1. 1Department of Paediatrics, Royal Alexandra Children’s Hospital, Brighton, UK
  2. 2Department of Paediatrics, Brighton and Sussex University NHS Trust, Brighton, UK
  1. Correspondence to Dr Leonie Perera, leonie.perera{at}


A 2-year-old girl presented with intermittent dysuria. Following triage in paediatric A+E, the nursing staff became concerned with the large sample of colourless urine she produced, which tested positive for leucocytes. She was described as a ‘big drinker’ to the SHO, raising concerns about diabetes insipidus. On detailed questioning it emerged that she had recently drunk a herbal tea preparation (buchu, couchgrass, marshmallow and plantain) to help ‘flush out’ her urinary system. She was advised to stop the tea. She had localised genital irritation and was discharged home with hygiene/barrier advice, pending urine culture results. She represented 2 days later with worsening dysuria and fever. Her urine was of normal colour and tested positive for leucocytes, nitrites and blood, hence she started antibiotics (urine cultures subsequently grew coliforms). Herbal use in children is not uncommon and should be considered as a cause of polyuria.

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