The main symptoms include:
• increased frequency of urination;
• dysuria (pain when urinating);
• Hematuria (presence of blood in the urine);
• clouding of urine.
In addition, the patient may be concerned about pain in the lower abdomen, and in some, urine has an unpleasant odor.
Cystitis in children
In young children, the symptoms of the disease may be more vague, namely:
• crying while urinating;
• Uncertain abdominal pain;
• low weight gain;
• fever;
• vomiting.
In children with increased body temperature, differential diagnosis should always be borne in mind cystitis. In elderly patients, UTIs may be asymptomatic or may manifest as pain in the abdomen and dimness of consciousness. Diagnosis of cystitis is based on clinical manifestations, as well as the results of microscopic examination and cultivation of urine. When suspected of cystitis, a diagnostic microscopy of the urine sample is performed. The presence of pus in the urine signals a bladder infection, responds to antibiotic treatment, does not require further analysis and observation. The recurrence of cystitis in an adult woman or the first attack of UTI in a child or a man dictates the need for a survey, since in such cases it can be said that there are predisposing conditions for the development of the disease.
Urine examination
With microscopic examination of urine, pyuria can be detected (the presence of pus in the urine, and, most importantly, the causative agent of the disease). For analysis, the average urine sample is collected in a sterile tube and examined under a microscope. Counting the cells can indicate the presence of inflammation in the urinary tract. The amount of a specific type of bacteria more than 100,000 colonies per 1 ml is considered pathological. It is necessary to observe special precautions in the study, so as not to get a false result due to contamination of urine by microbes from the outside. In rare cases, there is a need for suprapubic puncture of the bladder (inserting the needle into the bladder through the skin in the suprapubic region).
• Once the pathogen is identified, a sensitivity test for antibiotics is performed to determine the most effective drug.
• Escherichia coli - causes infection in 68% of cases.
• Proteus mirabiiis - 12%.
• Staphylococcus epidermidis - 10%.
• Streptococcus faecalis - 6%.
• Klebsiella aerogenes - 4%.
Interstitial cystitis
This term refers to chronic inflammation of the bladder, which is not based on a bacterial infection and which does not respond to antibiotic treatment. Symptoms of the disease are painful for the patient and include frequent, urgent urge to urinate and pain. The cause of the disease is unknown. Men from urinary tract infections protect the long urethra, as well as the bactericidal properties of the secretion of the prostate gland. In most cases, the cause of cystitis is the penetration of the intestinal flora through the urethra into the bladder. Factors contributing to the development of the disease in women include sexual contact, atrophic colpitis (after menopause) and pregnancy. In men, urinary tract infection can be caused by incomplete emptying of the bladder (for example, with prostatic hyperplasia) or structural abnormalities of the urinary tract.
The most frequent causative agents of cystitis are:
• Women have a short urethra and are therefore more prone to bladder infections, especially microorganisms of normal intestinal microflora. Often, the severity of symptoms requires immediate initiation of therapy with appropriate antibiotics. It is desirable to pre-obtain a sample of the average urine sample for microscopic examination and microbiological identification of the pathogen. Laboratory isolation of bacterial culture and determination of its sensitivity to antibiotics will allow selecting the most effective treatment. Sometimes it is necessary to begin therapy before receiving the results of urine culture. Relieve the condition of the patient with cystitis will allow fairly simple measures, in particular the daily intake of large amounts of liquid. It is also necessary to follow the rules of personal hygiene.
Drug therapy
For the treatment of urinary tract infections, one of these drugs, such as trimethoprim, cotrimoxazole, amoxicillin, nitrofurantoin and nalidixic acid, is usually prescribed. In some cases, one-time use of amoxicillin in a dose of 3 g for adults is sufficient to cure. Specialists recommend after the therapy to conduct a control study of the average portion of urine, to make sure the complete resolution of the infection. In all cases, UTI requires the intake of a large amount of fluid (at least three liters per day) in order to prevent stagnation of urine and suppress the reproduction of bacteria. In most cases of bacterial cystitis, the disease responds quickly to antibiotic therapy. In women with frequent relapses, as well as in men and children, a broader examination is conducted to identify the possible cause of the disease, in order to exclude or prevent more serious complications from the kidneys. Most infections of the lower urinary tract can be successfully treated with antibiotics, for example, trimethoprim.