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Acute Infective Cystitis

Last updated April 3, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Acute Infective Cystitis is an infection of the bladder and lower urinary tract.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Acute Bacterial Cystitis
  • Acute Bladder Infection
  • Acute Cystitis

What is Acute Infective Cystitis? (Definition/Background Information)

  • Acute Infective Cystitis is an infection of the bladder and lower urinary tract. The term ‘acute’ indicates that the infection occurs suddenly and is also severe
  • The condition is generally caused by pathogens, such as bacteria, which enters the urethra, travels to the bladder and causes an infection that may later spread to the kidneys. Most cases of Acute Infective Cystitis are cause by Escherichia coli, a bacterium found in the intestine
  • The common signs and symptoms of the infection are frequent, urgent, and painful urination; cramps in the lower abdomen and back; and low-grade fever. Acute Infective Cystitis may be diagnosed through urine analysis and culture tests
  • Oral antibiotics are the mainstay of treatment. The prognosis of Acute Infective Cystitis is generally good with appropriate treatment 

Who gets Acute Infective Cystitis? (Age and Sex Distribution)

  • Acute Infective Cystitis can affect any individual of any age
  • Women are more vulnerable to this condition than men, because of a shorter urethra and its closer proximity to the anus
  • The condition is observed worldwide; no racial or ethnic group predilection is present

What are the Risk Factors for Acute Infective Cystitis? (Predisposing Factors)

The following are the risk factors associated with Acute Infective Cystitis:

  • The risk increases as one ages; older individuals are generally more susceptible to Acute Infective Cystitis
  • Use of catheter, an external tube-like device that is inserted into the bladder and used for removing urine from the body
  • Blockage that occurs in the urethra or bladder due to congenital abnormalities
  • Blockage due to enlarged prostate (benign prostatic hyperplasia) and narrowed urethra (urethral stricture), as a result of scar tissue formation from a previous surgery
  • Uncontrolled type 1 and type 2 diabetes
  • Bowel incontinence, in which an individual is unable to control his/her bowel movements
  • Decreased immune system, due to a variety of health conditions
  • The use of certain birth-control devices such as a diaphragm
  • Menopausal women are higher prone to frequent urinary tract infections, which may lead to Acute Cystitis
  • Urinary retention, when an individual is unable to drain-off urine completely from the bladder, due to a variety of causes. This causes urine to collect in the bladder for a long period of time, creating an environment for bacteria to grow
  • Pregnancy can also cause urinary retention in the bladder, due to the pressure exerted by the growing baby
  • Certain surgical procedures involving the urinary tract can increase the risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Acute Infective Cystitis? (Etiology)

  • Acute Infective Cystitis is usually caused by bacterial infection, though other infectious organisms may also cause the condition
  • The most common bacteria that causes the condition is Escherichia coli (E.coli)
  • The pooling of urine in the bladder causes bacteria to grow in large numbers and infect the bladder wall. Occasionally, bacteria from the anus can infect the urinary tract due to poor hygiene

What are the Signs and Symptoms of Acute Infective Cystitis?

The signs and symptoms associated with Acute Infective Cystitis include:

  • Frequent urination and excessive urge to urinate; also, increased urge to urinate at night
  • Cloudy colour of the urine
  • Burning sensation and pain while urinating
  • Bad and strong urinary odour
  • Blood in urine
  • Mild fever and fatigue
  • Cramping pains in the lower abdomen, cramps in the back
  • Elderly individuals with severe infections may have symptoms, such as mental changes and confusion, especially when the infection spreads into the bloodstream, and to other parts of the body

How is Acute Infective Cystitis Diagnosed?

The diagnosis of Acute Infective Cystitis may involve:

  • Complete evaluation of medical history along with a thorough physical exam
  • Urinalysis to analyse the urine for:
    • White blood cells
    • Red blood cells       
    • Bacteria
    • Presence of certain chemicals such as nitrates
  • Urine culture:
    • This test helps in determining the cause of Acute Infective Cystitis, such as to identify the bacteria that causes the infection
    • It also helps in determining the correct antibiotics that can be used in treatment (culture susceptibility testing)       
  • Depending on individual circumstances, radiological studies, such as ultrasound of abdomen, CT scan of abdomen, and contrast studies, may be undertaken
  • Occasionally, the healthcare provider may perform a cystoscopy to determine the cause of recurrent cystitis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Infective Cystitis?

The possible complications that may arise due to Acute Infective Cystitis include:

  • Kidney infection (pyelonephritis)
  • Acute kidney failure (acute renal failure)
  • Recurrence of urinary tract infection
  • Septicemia: The infection may spread into the bloodstream causing infection of other body organs

How is Acute Infective Cystitis Treated?

Acute Infective Cystitis is usually treated with oral antibiotics. The duration of the antibiotic therapy shall be determined by the healthcare provider.

  • If the infection affects individuals with risk factors, such as pregnancy, uncontrolled type 1 or type 2 diabetes, and kidney failure, the healthcare provider may prescribe antibiotics for a longer period of time
  • Individuals should not discontinue the antibiotics, just because there is an improvement in the signs and symptoms. The full course of antibiotic therapy should be taken, as prescribed. Partial treatment of Acute Cystitis due to premature discontinuation of antibiotics can cause antibiotic resistance in the bacteria. This is a significant risk factor for recurrent cystitis
  • The healthcare provider may also prescribe medications to help with burning sensation and urgent urination urge. Drinking plenty of water/fluids is also advised
  • Women with recurrent infection may be treated  in the following manner:
    • Acute Cystitis Infection that occurs after a sexual activity may be treated with a single dose of antibiotics
    • Ascorbic acid and cranberry juice may be recommended as they have the ability to increase the acid content in the urine, which may be helpful in reducing the bacteria in urine       
  • Follow-up urine cultures may be performed to determine the effectiveness of the antibiotic therapy. This follow-up urine culture is usually performed, any time after 10 days, after the last day of prescribed antibiotic treatment
  • Do not miss any scheduled follow-up appointments with the healthcare provider.

How can Acute Infective Cystitis be Prevented?

Following are the preventive measures for Acute Infective Cystitis:

  • Drinking plenty of fluids is advisable, cranberry juice and cranberry tablets may also be used
  • Drinking alcohol and caffeine should be avoided, since these tend to irritate the bladder
  • Emptying the bladder before and after a sexual intercourse may also help. This is because the bacteria exchanged during a sexual intercourse from the partner can be flushed-out through the process of urination
  • Frequent urination can help expel bacteria from the body
  • Use of estrogen creams (in the vagina) after menopause can help prevent vaginal infections
  • Use of sanitary pads, instead of tampons, are highly recommended, since it is believed that tampons can cause infections to a larger extent
  • Changing sanitary pads frequently (during a period) can help avoid infections
  • Avoid using sprays and perfumes on the genital area
  • It is preferable to shower than take baths; avoid oil baths
  • Genital areas should always be kept clean; the genital and anal areas should be cleaned immediately after any sexual activity
  • In women, wiping from front to back after urination or passing stools is recommended
  • Avoid tight-fitting clothes
  • Use cotton underwear and panties; it is also recommended that they be changed every day

What is the Prognosis of Acute Infective Cystitis? (Outcomes/Resolutions)

Following is the prognostic information for Acute Infective Cystitis:

  • The prognosis depends upon the overall health of the individual. In majority of cases, it is excellent with appropriate treatment
  • Early diagnosis and complete treatment can help prevent recurrent Acute Cystitis
  • Individuals with uncontrolled diabetes (type 1 and type 2), lowered immune systems, and those with antibiotic-resistant infections may have to be treated aggressively

Additional and Relevant Useful Information for Acute Infective Cystitis:

  • The urine culture test is a urine test that helps detect the presence of microorganisms in the urine

The following article link will help you understand urine culture test:

http://www.dovemed.com/common-procedures/procedures-laboratory/urine-culture-test/ 

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 5, 2015
Last updated: April 3, 2018