Cystitis in children

Abstract

Cystitis due to bacterial infection is a common occurrence in pre-school and school-aged girls, causing symptoms of frequency and urgency, wetting and pain on voiding. General symptoms and fever are rare in the absence of ascending infection resulting from vesico-ureteral reflux. The condition responds rapidly to appropriate antimicrobial therapy, although recurrence or persistence of asymptomatic bacilluria is common. In the past, recurrent urinary tract infection (UTI) had been mainly referred to congenital urological anomalies. Nowadays, major malformations are basically screened by antenatal or postnatal ultrasound and, in the majority of cases, recurrence of cystitis is strongly related with underlying bladder-sphincter dysfunction. Moreover, a pathophysiologic relationship between bladder dysfunction, urinary tract infection and development of vesico-ureteral reflux has been well known from more than three decades. Therefore, the most effective intervention to prevent recurrence of infection and possible upper urinary tract involvement in neurologically normal and toilet-trained children is considered to identify and treat voiding dysfunction. Non-specific forms of acute and chronic cystitis are rare in children. Nevertheless, owing to the growing interest on interstitial cystitis in adult patients, there is recent evidence of occurrence of this pathologic entity even in children. ©2005, Editrice Kurtis.