Acute cystitis: Clinical features and diagnosis in children older than two years and adolescents
- Debra L Palazzi, MD, MEd
Debra L Palazzi, MD, MEd
- Associate Professor of Pediatrics, Infectious Diseases Section
- Baylor College of Medicine
- Judith R Campbell, MD
Judith R Campbell, MD
- Professor of Pediatric Infectious Diseases
- Baylor College of Medicine
- Section Editors
- Tej K Mattoo, MD, DCH, FRCP
Tej K Mattoo, MD, DCH, FRCP
- Section Editor — Pediatric Nephrology
- Professor of Pediatrics
- Wayne State University School of Medicine
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Cystitis is inflammation of the urinary bladder, usually caused by infection, which can occur alone or in conjunction with pyelonephritis.
The clinical features and diagnosis of acute cystitis in children older than two years and adolescents will be reviewed here. The management and prognosis of acute cystitis in children older than two years and adolescents is discussed separately. (See "Acute cystitis: Management and prognosis in children older than two years and adolescents".)
Urinary tract infection (UTI) in newborns and children younger than two years (in whom it is difficult to distinguish cystitis from pyelonephritis on clinical grounds) also is discussed separately.
- Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 2008; 27:302.
- Edlin RS, Shapiro DJ, Hersh AL, Copp HL. Antibiotic resistance patterns of outpatient pediatric urinary tract infections. J Urol 2013; 190:222.
- Schlager TA, Whittam TS, Hendley JO, et al. Comparison of expression of virulence factors by Escherichia coli causing cystitis and E. coli colonizing the periurethra of healthy girls. J Infect Dis 1995; 172:772.
- Hooton TM, Scholes D, Hughes JP, et al. A prospective study of risk factors for symptomatic urinary tract infection in young women. N Engl J Med 1996; 335:468.
- Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am 1997; 11:551.
- Siroky MB. Pathogenesis of bacteriuria and infection in the spinal cord injured patient. Am J Med 2002; 113 Suppl 1A:67S.
- Elliott SP, Villar R, Duncan B. Bacteriuria management and urological evaluation of patients with spina bifida and neurogenic bladder: a multicenter survey. J Urol 2005; 173:217.
- Langley JM, Hanakowski M, Leblanc JC. Unique epidemiology of nosocomial urinary tract infection in children. Am J Infect Control 2001; 29:94.
- Stover BH, Shulman ST, Bratcher DF, et al. Nosocomial infection rates in US children's hospitals' neonatal and pediatric intensive care units. Am J Infect Control 2001; 29:152.
- Bi XC, Zhang B, Ye YK, et al. Pathogen incidence and antibiotic resistance patterns of catheter-associated urinary tract infection in children. J Chemother 2009; 21:661.
- Rosenthal VD, Bijie H, Maki DG, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. Am J Infect Control 2012; 40:396.
- Davis KF, Colebaugh AM, Eithun BL, et al. Reducing catheter-associated urinary tract infections: a quality-improvement initiative. Pediatrics 2014; 134:e857.
- Chang SL, Shortliffe LD. Pediatric urinary tract infections. Pediatr Clin North Am 2006; 53:379.
- Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med 2002; 113 Suppl 1A:14S.
- Mufson MA, Belshe RB. A review of adenoviruses in the etiology of acute hemorrhagic cystitis. J Urol 1976; 115:191.
- Cherry JD, Nadipuram S. Adenoviruses. In: Feigin and Cherry’s Textbook of Pediatric Infectious Diseases, 7th ed, Cherry JD, Harrison GJ, Kaplan SL, et al (Eds), Elsevier Saunders, Philadelphia 2014. p.1888.
- Brouwer KC, Ndhlovu PD, Wagatsuma Y, et al. Urinary tract pathology attributed to Schistosoma haematobium: does parasite genetics play a role? Am J Trop Med Hyg 2003; 68:456.
- Kauffman CA, Vazquez JA, Sobel JD, et al. Prospective multicenter surveillance study of funguria in hospitalized patients. The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group. Clin Infect Dis 2000; 30:14.
- Eriksson A, Giske CG, Ternhag A. The relative importance of Staphylococcus saprophyticus as a urinary tract pathogen: distribution of bacteria among urinary samples analysed during 1 year at a major Swedish laboratory. APMIS 2013; 121:72.
- Hofland CA, Eron LJ, Washecka RM. Hemorrhagic adenovirus cystitis after renal transplantation. Transplant Proc 2004; 36:3025.
- Ison MG. Adenovirus infections in transplant recipients. Clin Infect Dis 2006; 43:331.
- Boeckh M, Erard V, Zerr D, Englund J. Emerging viral infections after hematopoietic cell transplantation. Pediatr Transplant 2005; 9 Suppl 7:48.
- Erard V, Storer B, Corey L, et al. BK virus infection in hematopoietic stem cell transplant recipients: frequency, risk factors, and association with postengraftment hemorrhagic cystitis. Clin Infect Dis 2004; 39:1861.
- Azzarone G, Liewehr S, O'Connor K. Cystitis. Pediatr Rev 2007; 28:474.
- Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children. N Engl J Med 2011; 365:239.
- Duffy MA, Hernandez-Santiago V, Orange G, et al. Trimethoprim prescription and subsequent resistance in childhood urinary infection: multilevel modelling analysis. Br J Gen Pract 2013; 63:e238.
- Hooton TM, Scholes D, Stapleton AE, et al. A prospective study of asymptomatic bacteriuria in sexually active young women. N Engl J Med 2000; 343:992.
- Mayersak JS, Viviano CJ. Severe chemical cystitis from the transurethral intravesical insertion of a vaginal contraceptive suppository: a report of 3 cases and proposed method of management. J Urol 1993; 149:835.
- Wald ER. Cystitis and pyelonephritis. In: Feigin and Cherry’s Textbook of Pediatric Infectious Diseases, 7th ed, Cherry JD, Harrison GJ, Kaplan SL, et al (Eds), Elsevier Saunders, Philadelphia 2014. p.535.
- Shaikh N, Shope TR, Hoberman A, et al. Association Between Uropathogen and Pyuria. Pediatrics 2016; 138.
- Shaikh N, Morone NE, Lopez J, et al. Does this child have a urinary tract infection? JAMA 2007; 298:2895.
- Hoberman A, Wald ER, Penchansky L, et al. Enhanced urinalysis as a screening test for urinary tract infection. Pediatrics 1993; 91:1196.
- Huicho L, Campos-Sanchez M, Alamo C. Metaanalysis of urine screening tests for determining the risk of urinary tract infection in children. Pediatr Infect Dis J 2002; 21:1.
- Gorelick MH, Shaw KN. Screening tests for urinary tract infection in children: A meta-analysis. Pediatrics 1999; 104:e54.
- KASS EH. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians 1956; 69:56.
- Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128:595.
- Reaffirmation of AAP clinical practice guideline: The diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months of age. Pediatrics 2016; 138:e20163026.
- Allen CW, Alexander SI. Adenovirus associated haematuria. Arch Dis Child 2005; 90:305.
- Ciftci AO, Senocak ME, Tanyel FC, Büyükpamukçu N. Clinical predictors for differential diagnosis of acute scrotum. Eur J Pediatr Surg 2004; 14:333.
- Orth RW, Weisman MH, Cohen AH, et al. Lupus cystitis: primary bladder manifestations of systemic lupus erythematosus. Ann Intern Med 1983; 98:323.
- Uncomplicated cystitis
- Complicated cystitis
- RISK FACTORS
- CLINICAL PRESENTATION
- Physical examination
- Laboratory evaluation
- Clinical suspicion
- Urine culture
- - Bacterial culture
- - Viral culture
- - Fungal culture
- DIFFERENTIAL DIAGNOSIS
- EVALUATION FOR UNDERLYING ABNORMALITIES
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS