Cystitis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]
Overview
Cystitis must be differentiated from other causes of dysuria such as acute pyelonephritis, urethritis, prostatitis, vulvovaginitis, urethral strictures or diverticula, benign prostatic hyperplasia and neoplasms such as renal cell carcinoma and cancers of the bladder, prostate, and penis. It must also be differentiated from sexually transmitted diseases such as syphilis.[1][2][3]
Differential Diagnosis
Cystitis must be differentiated from other causes of dysuria such as:[2][3][4]
- Acute pyelonephritis
- Ureteritis
- Urethritis
- Prostatitis
- Vulvovaginitis
- Cervicitis
- Urethral strictures or diverticula
- Benign prostatic hyperplasia
- Syphilis
- Genital Herpes
- Neoplasms such as renal cell carcinoma and cancers of the bladder, prostate, and penis
Cystitis must also be differentiated from sexually transmitted diseases, such as syphilis.[1]
Cystitis must be differentiated from other diseases that cause lower urinary tract irritation symptoms, such as: dysuria, urgency and frequency in addition to urethral dyscharge , the differential list include: urethritis, cervicitis, vulvovaginitis, epididimitis, prostatitis , and syphilis.[3]
| Disease | Findings |
|---|---|
| Cystitis | Bladder inflammation, Features with increased frequency and urgency, dysuria, and suprapubic pain. Is more common among women. E.coli is the most common pathogen[5][6][7][8]. |
| Urethritis | infection of the urethra,causes dysuria and urethral discharge[9][10][11] |
| Bacterial vulvovaginitis | Presents with dysuria and pruritus, Vaginal discharge and odor are almost always present, caused by Gardnerella species[12]. |
| Cervicitis | Often asymptomatic,some women have an abnormal vaginal discharge and vaginal bleeding (especially after sexual intercourse)[13] |
| Prostatitis | bacterial infection of the prostate,causes discomfort during ejaculation[14] |
| Epididymitis | Presents with scrotal pain and swelling accompanied by fever and lower urinary tract irritation symptoms(dysuria and frequency)[15]. |
| Syphilis | Presents with generalized systemic symptoms such as malaise, fatigue, headache and fever. Skin eruptions may be subtle and asymptomatic. It is classically described as 1) non-pruritic bilateral symmetrical mucocutaneous rash; 2) non-tender regional lymphadenopathy; 3) condylomata lata; and 4) patchy alopecia.[16] |
References
- ↑ 1.0 1.1 Workowski, KA.; Berman, S.; Workowski, KA.; Bauer, H.; Bachman, L.; Burstein, G.; Eckert, L.; Geisler, WM.; Ghanem, K. (2010). "Sexually transmitted diseases treatment guidelines, 2010". MMWR Recomm Rep. 59 (RR-12): 1–110. PMID 21160459. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 Bremnor JD, Sadovsky R (2002). "Evaluation of dysuria in adults". Am Fam Physician. 65 (8): 1589–96. PMID 11989635.
- ↑ 3.0 3.1 3.2 Kurowski K (1998). "The woman with dysuria". Am Fam Physician. 57 (9): 2155–64, 2169–70. PMID 9606306.
- ↑ IMMERGUT S, COTTLER ZR (1950). "Mucin producing adenocarcinoma of the bladder associated with cystitis follicularis and glandularis". Urol Cutaneous Rev. 54 (9): 531–4. PMID 15443228.
- ↑ Stephen Bent, Brahmajee K. Nallamothu, David L. Simel, Stephan D. Fihn & Sanjay Saint (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA. 287 (20): 2701–2710. PMID 12020306. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm (1981). "Etiology and management of the acute urethral syndrome". Sexually transmitted diseases. 8 (3): 235–238. PMID 7292216. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm, K. F. Wagner, R. Amsel, E. R. Alexander, M. Turck, G. W. Counts & K. K. Holmes (1980). "Causes of the acute urethral syndrome in women". The New England journal of medicine. 303 (8): 409–415. doi:10.1056/NEJM198008213030801. PMID 6993946. Unknown parameter
|month=ignored (help) - ↑ Leonie G. M. Giesen, Grainne Cousins, Borislav D. Dimitrov, Floris A. van de Laar & Tom Fahey (2010). "Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs". BMC family practice. 11: 78. doi:10.1186/1471-2296-11-78. PMID 20969801.
- ↑ Taylor-Robinson D (1996). "The history of nongonococcal urethritis. Thomas Parran Award Lecture". Sex Transm Dis. 23 (1): 86–91. PMID 8801649.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
- ↑ Daniel V. Landers, Harold C. Wiesenfeld, R. Phillip Heine, Marijane A. Krohn & Sharon L. Hillier (2004). "Predictive value of the clinical diagnosis of lower genital tract infection in women". American journal of obstetrics and gynecology. 190 (4): 1004–1010. doi:10.1016/j.ajog.2004.02.015. PMID 15118630. Unknown parameter
|month=ignored (help) - ↑ Kimberly A. Workowski & Gail A. Bolan (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. PMID 26042815. Unknown parameter
|month=ignored (help) - ↑ Felix Millan-Rodriguez, J. Palou, Anna Bujons-Tur, Mireia Musquera-Felip, Carlota Sevilla-Cecilia, Marc Serrallach-Orejas, Carlos Baez-Angles & Humberto Villavicencio-Mavrich (2006). "Acute bacterial prostatitis: two different sub-categories according to a previous manipulation of the lower urinary tract". World journal of urology. 24 (1): 45–50. doi:10.1007/s00345-005-0040-4. PMID 16437219. Unknown parameter
|month=ignored (help) - ↑ A. Stewart, S. S. Ubee & H. Davies (2011). "Epididymo-orchitis". BMJ (Clinical research ed.). 342: d1543. PMID 21490048.
- ↑ Moore, Zack S; Seward, Jane F; Lane, J Michael (2006). "Smallpox". The Lancet. 367 (9508): 425–435. doi:10.1016/S0140-6736(06)68143-9. ISSN 0140-6736.