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Acute cystitis

Última revisão: 23 Sep 2025
Última atualização: 19 Jun 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • dysuria
  • urgency
  • frequency
  • suprapubic pain
  • prior history of urinary tract infections (UTIs) and treatment history
Detalhes completos

Outros fatores diagnósticos

  • recent urinary tract instrumentation
  • flank pain
  • abdominal pain
  • fever
  • vaginal discharge
  • vaginal pruritus
  • dyspareunia
  • structurally or functionally abnormal bladder
Detalhes completos

Fatores de risco

  • frequent sexual intercourse
  • history of UTI
  • anatomic or functional abnormalities within the urinary tract
  • spermicidal jelly
  • urinary catheter
  • asymptomatic bacteriuria during pregnancy or prior to urological surgery
  • diabetes
  • spinal cord injuries
  • pregnancy
  • immunosuppression
  • older age
  • lack of circumcision
  • age <15 years for first UTI
  • new sex partner in past year
  • UTI history in mother
  • diaphragm use
  • obesity
  • vaginal atrophy
  • low socioeconomic status
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • urinalysis
  • urine microscopy
  • urine culture with sensitivity
Detalhes completos

Investigações a serem consideradas

  • pregnancy test
Detalhes completos

Algoritmo de tratamento

AGUDA

uncomplicated urinary tract infection (UTI): nonpregnant

complicated UTI: nonpregnant

uncomplicated or complicated UTI: pregnant

CONTÍNUA

​​at risk of chronic recurrent UTI

Colaboradores

Autores

Christopher Chapple, BSc, MD, FRCS (Urol), FEBU

Honorary Senior Lecturer of Urology

University of Sheffield

Consultant Urological Surgeon

Department of Urology

Royal Hallamshire Hospital

Sheffield

UK

Declarações

CC is a consultant for MUVON Therapeutics, Proverum (on safety committee), Symimetic (non-financial), and Urovant Sciences. He is an author for Astellas and Ferring. He is a speaker for Allergan.

Altaf Mangera, MBChB (Hons), MD, FRCS (Urol), FEBU

Consultant Urologist

Department of Urology

Royal Hallamshire Hospital

Sheffield

UK

Declarações

AM declares that he has no competing interests.

Agradecimentos

Dr Christopher Chapple and Dr Altaf Mangera would like to gratefully acknowledge Dr Michael K. Park, a previous contributor to this topic.

Declarações

MKP declares that he has no competing interests.

Revisores

James Malone-Lee, MD, FRCP

Professor of Medicine

Department of Clinical Physiology

Division of Medicine

Whittington Campus

University College London Medical School

London

UK

Declarações

JML declares that he has no competing interests.

David Chelmow, MD

Chair

Department of Obstetrics and Gynecology

Virginia Commonwealth University

Richmond

VA

Declarações

DC declares that he has no competing interests.

Créditos aos pareceristas

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Referências

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Principais artigos

European Association of Urology. Guidelines on urological infections. 2023 [internet publication].Texto completo

American Urological Association. ​Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. 2022 [internet publication].Texto completo

Nicolle LE, Gupta K, Bradley SF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019 May 15;68(10):e83-110.​Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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