Cystitis

Question 1

What is cystitis?

Answer 1

This is a lower urinary tract infection or inflammation of the U.B

Acute bacterial cystitis is an infection of the bladder with organisms that ascended from the urethra

Question 2

Clinical picture of cystitis

Answer 2

Frequency 
Urgency
Nocturia 
Dysuria
Patients also complain of low back pain or suprapubic pain
Fever is unusual

Question 3

Diagnosis of cystitis

Answer 3

-urinalysis; pyuria(presence of 10 or more WBCs per cubic millimetre in a urine specimen), bacteriuria and hematuria
Urine cultures are positive for E.Coli, a persistent Proteus infection sheldon suggest possibility of an infected struvite stone

Females have higher incidence of cystitis which increases throughout their lifetime , reoccurrence is associated with coliform bacterial colonization of the urethra and vaginal vestibule
Males are more likely to have other associated urinary problems like prostitis, urethritis etc
Children with a UTI particularly infants should be thoroughly evaluated with VCUG and renal US( VCUG is postponed to 4-6weeks because of incidence of low grade reflux.

Question 4

Treatment of cystitis

Answer 4

Short course 3 days or single dose therapy is effective as 7-14days of therapy in adult non diabetic females and children with uncomplicated lower UTIs of less than two days duration
Sulfonamides , trimethoprim- sulfamethoxazole and nitrofurantoins are effective in initial therapy
Antibiotics use is guided by sensitivity test

Question 5

What is Pyocystitis?

Answer 5

Collection of pus within the bladder

Occurs most in dialysis patients with low or absent urine output

Question 6

Clinical picture of pyocystitis

Answer 6

Fever
Suprapubic pain
Palpable mass

Question 7

Diagnosis of pyocystitis

Answer 7

Pelvic US

Diagnostic bladder aspiration

Question 8

Treatment of pyocystitis

Answer 8

Draining the bladder and antibiotics

Question 9

What is emphysamatous cystitis?

Answer 9

It is a rare manifestation of UTI characterised by gad within the bladder of its muscular wall

Question 10

Etiology of emphysamatous cystitis

Answer 10

Usually occurs in severe diabetic patients
Caused by E.Coli, Proteus, Pseudomonas and rarely clostridia
Instrumentation and colovesical Fistulas

Question 11

Diagnosis of emphysamatous cystitis

Answer 11

Radiography of kidney, ureter, bladder(KUB) is pathogenic

Cystography will confirm the location of the gas

Question 12

Treatment of emphysamatous cystitis

Answer 12

Antibiotics, control of glucosuria, relief of any outlet obstruction