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Cistite aguda

Última revisión: 13 Sep 2025
Última actualización: 19 Jun 2025

Resumen

Definición

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • disúria
  • urgência
  • polaciúria
  • dor suprapúbica
  • história pregressa de infecções do trato urinário (ITUs) e história de tratamentos
Full details

Other diagnostic factors

  • instrumentação recente do trato urinário
  • dor no flanco
  • dor abdominal
  • febre
  • corrimento vaginal
  • prurido vaginal
  • dispareunia
  • bexiga estruturalmente ou funcionalmente anormal
Full details

Risk factors

  • relação sexual frequente
  • história de infecção do trato urinário (ITU)
  • anormalidades anatômicas ou funcionais no trato urinário
  • gel espermicida
  • cateter urinário
  • bacteriúria assintomática durante gestação ou antes de uma cirurgia urológica
  • diabetes
  • lesões da medula espinhal
  • gestação
  • imunossupressão
  • idade avançada
  • ausência de circuncisão
  • idade <15 anos para a primeira ITU
  • novo parceiro sexual no último ano
  • mãe com história de ITU
  • uso de diafragma
  • obesidade
  • atrofia vaginal
  • condição socioeconômica baixa
Full details

Diagnostic investigations

1st investigations to order

  • urinálise
  • microscopia da urina
  • cultura de urina com teste de sensibilidade
Full details

Investigations to consider

  • teste de gravidez
Full details

Treatment algorithm

ACUTE

infecção do trato urinário (ITU) não complicada: não gestante

infecção do trato urinário (ITU) complicada: não gestante

infecção do trato urinário (ITU) complicada ou não complicada: gestante

ONGOING

em risco de infecção do trato urinário (ITU) crônica recorrente

Contributors

Authors

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

Disclosures

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

Disclosures

AM declares that he has no competing interests.

Acknowledgements

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

Disclosures

MKP declares that he has no competing interests.

Peer reviewers

James Malone-Lee, MD, FRCP

Professor of Medicine

Department of Clinical Physiology

Division of Medicine

Whittington Campus

University College London Medical School

London

UK

Disclosures

JML declares that he has no competing interests.

David Chelmow, MD

Chair

Department of Obstetrics and Gynecology

Virginia Commonwealth University

Richmond

VA

Disclosures

DC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

European Association of Urology. Guidelines on urological infections. 2023 [internet publication].Full text

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

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.Full text

National Institute for Health and Care Excellence. Urinary tract infection (lower): antimicrobial prescribing (NG109). Oct 2018 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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