Infectious/Inflammatory Conditions

Question 1

What is cystitis?

Answer 1

Acute cystitis is an infection of the bladder. The route of infection is typically ascending from the urethra.

Question 2

What is the most common cause of cystitis?

Answer 2

Cystitis is most commonly due to the coliform bacteria (especially E. Coli) and occasionally to gram-positive bacteria (enterococci).

Question 3

What are the signs and symptoms of cystitis?

Answer 3

Irritative voiding symptoms (frequency, urgency and dysuria) and suprapubic discomfort are common. Symptoms may present after intercourse.

Physical exam may elicit suprapubic tenderness but the examination is often unremarkable.

Question 4

What are the laboratory findings for cystitis?

Answer 4

UA shows pyuria and bacteriuria and varying degrees of hematuria. Urine culture is positive for the offending organism, but colony counts exceeding 10^5 are not essential for diagnosis.

Question 5

How do we prevent cystitis?

Answer 5

Women who have more than 3 episodes of cystitis per year are considered candidates for prophylactic antibiotic therapy to prevent recurrence after treatment of a UTI. The most common oral agents for prophylaxis are trimethoprim-sulfamethoxazole, nitrofurantoin, and cephalexin.

Question 6

How do we treat cystitis?

Answer 6

Uncomplicated cystitis in women can be treated with short term anti microbial therapy, which consists of single dose therapy. Cephalexin, Nitrofurantoin and fluoroquinolones are the drugs of choice.