Cystitis

Cystitis
Refers to urinary infection of the lower urinary tract, principally the bladder. Acute cystitis more commonly affects women than men. The principle mode of infection is ascending from perurethral/vaginal and fecal flora.
Presentation and findings
Patients with acute cystitis present with irritative voiding symptoms such as dysuria, frequency, and urgency. Low back and suprapubic pain, hematuria, and cloudy/foul smelling urine are also common symptoms. Typically, urinalysis demonstrates WBCs in the urine, and hematuria may present. Urine culture is require to confirm the diagnosis. E. coli causes most of the acute cystitis. Other gram-negative (klebsiella and proteus spp.).
Radiological imaging
In uncomplicated infection of the bladder is often not necessary.



Management
Short course of oral antibiotics. TMS-SMX, nitrofurantoin, and fluroquinolones have excellent activity against most pathogens that cause cystitis. In adult and children, the duration of treatment is usually limited to 3-5 days.
Recurrent cystitis
presentation and findings
Recurrent cystitis is caused either by bacterial persistence or reinfection with another organism.

Radiological imaging
When bacterial persistence is the suspected cause, radiological imaging is indicated. Ultrasonography can be obtained to provide screening evaluation of the genitourinary tract, intravenous pyelography, cystoscopy, and CT scan may occasionally necessary.