Cystitis

The most common renal disease is a urinary tract infection (UTI). Infection may involve the lower urinary
tract (urethra and bladder) or the upper urinary tract (renal pelvis, tubules, and interstitium). Most
frequently encountered is infection of the bladder or cystitis. It is common in women and children

Presence of signs and symptoms of cystitis like dysuria, nocturia, frequency and urgency increase the

probability of confirmation of cystitis as the diagnosis. Laboratory tests used in the diagnosis and confirmation
of cystitis include urinalysis and urine culture.

Pathophysiology

Cystitis usually develops due to the colonization of the periurethral mucosa by bacteria from the fecal or
vaginal flora and ascension of such pathogens to the urinary bladder. Uropathogens may have microbial
virulence factors that allow them to escape host defenses and invade host tissues in the urinary tract. UTI
in males is much less common due to the longer anatomic urethra and antibacterial defenses provided by
the prostatic fluid.

Urine sample collection

- The perineal area must be cleansed with an antiseptic or soap in young male or female children.
- Midstream clean catch of urine in a wide mouth bottle or container

Urinalysis

- Presence of nitrites or leukocyte esterase on dipstick or presence of WBCs of bacteria on microscopic

examination suggests the presence of a urinary tract infection. Urinalysis reveals the presence of
numerous WBCs and bacteria, often accompanied by mild proteinuria and hematuria and an
increased pH.

Urine culture

Bacterial culture -  urine culture (clean catch) or catheterized urine specimen may be performed to determine
the type of bacteria in the urine and the appropriate antibiotic for treatment. UTI will have > 100,000 colonies
of organism (CFU/mL).

Viral culture - The viruses involved in causing cystiti

include HIV, adenovirus, cytomegalovirus and polyoma viruses. Viral cultures are only done
in immunocompromised individuals or in those patients in whom the urinalysis and bacterial cultures are
negative despite symptoms

Fungal Culture - Candida is the most common fungus associated with fungal cystitis. Fungal cystitis is a rare
when compared with bacteria cystitis. It can cause cystitis in immunocompromised patients only and presence
of fungus in the urine is sometimes evaluated in hospitalised patients.