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B - Paediatrics MANAGEMENT > Cystitis > Flashcards

Cystitis Flashcards

1
Q

What is cystitis?

A

Inflammation of the urinary bladder that can occur alone or in conjunction with pyelonephritis

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2
Q

What is the most common cause of cystitis?

A

UTI

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3
Q

Where can UTI’s affect?

A

Any part of the urinary tract

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4
Q

How do lower UTI’s typically occur?

A

Pathogens that colonise periurethral areas ascend the urethra to the bladder

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5
Q

Where can pathogens spread to once they reach the bladder?

A
  • Ureters
  • Kidneys
  • Bloodstream
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6
Q

What is often seen in infants under 2 months with a UTI?

A

Poor containment of infection and spread to bacteraemia

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7
Q

What organism causes 90% of UTI’s?

A

E. coli

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8
Q

What other bacteria can cause UTI’s?

A
  • Klebsiella
  • Proteus
  • Enterococcus
  • Staphylococcus saprophyticus
  • Group B Strep
  • Pseudomonas aeruginosa
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9
Q

When are fungi more likely to be the cause of a UTI?

A

After instrumentation of the urinary tract

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10
Q

What are the risk factors for developing a UTI?

A
  • Antibiotic therapy
  • Anatomical abnormalities
  • Bowel and urinary bladder dysfunction
  • Urinary retention
  • VUR
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11
Q

Why can antibiotic therapy increase risk of developing a UTI?

A

Alters the periurethral flora

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12
Q

What are the signs and symptoms of UTI in a 0-2 month old?

A
  • Jaundice
  • Fever
  • Failure to thrive
  • Poor feeding
  • Vomiting
  • Irritability
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13
Q

What are the signs and symptoms of UTI in a 2 month - 2 year old?

A
  • Poor feeding
  • Vomiting
  • Strong smelling urine
  • Abdominal pain
  • Irritability
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14
Q

What are the signs and symptoms of UTI in a 2-6 year old?

A
  • Vomiting
  • Abdominal pain
  • Fever
  • Strong smelling urine
  • Enuresis
  • Dysuria
  • Frequency
  • Urgency
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15
Q

What are the signs and symptoms of UTI in a 6+ year old?

A
  • Fever
  • Vomiting and abdominal pain
  • Strong smelling urine
  • Dysuria
  • Urgency
  • Frequency
  • Enuresis
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16
Q

Who is more likely to present with typical urinary symptoms in a UTI?

A

Adolescents

17
Q

What is required to diagnose a UTI in a child?

A

Urine culture

18
Q

How should culture sample be obtained in children with urinary control?

A

Mid-stream, clean catch specimen

19
Q

Why is obtaining a urine sample for culture in younger children more difficult?

A

They are unable to void on request

20
Q

How should urine sample be obtained in children unable to void on request?

A

Suprapubic aspiration or urethral cathaterisation

21
Q

What results on sample culture indicate probable infection?

A

Bacterial culture of more than 10^5 colony forming units of a single organism

22
Q

What does a mixed growth usually suggest?

A

Contamination

23
Q

What group of children should undergo imaging following UTI diagnosis?

A

Only those with an atypical UTI

24
Q

What are some features of an atypical UTI?

A
  • Seriously ill/septic
  • Poor urine flow
  • Abdominal or bladder mass
  • Raised creatinine
  • Failure to respond to suitable antibiotics within 48 hours
  • Infection with atypical organisms
25
Q

What is the first imaging test conducted in an atypical UTI investigation?

A

Renal USS

26
Q

What can a renal USS identify?

A

Serious structural abnormalities, urinary obstruction and renal defects

27
Q

What do subsequent investigations depend on?

A

Results of USS

28
Q

What are some differentials of a UTI?

A
  • Epididymitis/orchitis
  • Prostatitis
  • Urethritis
  • Pregnancy
  • Urolithiasis
  • Bladder and bowel dysfunction
29
Q

How should infants under 3 months be managed with suspected UTI?

A

Immediate referral to hospital for IV antibiotics e.g. co-amoxiclav for 5-7 days

30
Q

How can older children be treated for cystitis?

A

Oral antibiotics e.g. trimethoprim/nitrofurantoin for 3 days

31
Q

What should parents be given regarding UTI’s?

A

Advice on how to prevent further infections

32
Q

How can further UTI be prevented?

A
  • High fluid intake
  • Regular voiding
  • Ensure complete bladder emptying
  • Treatment/prevention of constipation
  • Good perineal hygiene
  • Lactobacillus acidophilus probiotic
33
Q

How can parents encourage their child to fully empty their bladder?

A

Encourage trying to go a second time a few minutes later

34
Q

What are the potential complications of a UTI?

A
  • Pyelonephritis
  • Sepsis
  • Dehydration

B - Paediatrics MANAGEMENT (106 decks)

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