Reference no: EM133916579

Question

A 23-year-old woman was married a year ago. Since then, she has experienced five attacks of acute cystitis, all characterized by dysuria, increased frequency, and urgency. Each case was diagnosed on the basis of the clinical picture and a laboratory urinalysis finding of bacteriuria. The urine bacterial counts in these cases ranged from 10^4 to 10^6 organisms/mL. Lab tests indicated that the first, second, and fifth infections were caused by Escherichia coli, while the third infection was caused by an enterococcus and the fourth infection was caused by proteus mirabilis. Each infection responded to short-term treatment with trimethoprimsul famethoxazole. The recurrences occurred at intervals of 3 weeks to 3 months following completion of antibiotic therapy.

For the past two days, she has once again been experiencing dysuria, increased frequency, and urgency, so she goes to see her physican. Her vital signs are T= 99F, P=100/min, RR=18/min,and BP=110/70 mm/Hg. physical examination reveals a mild tenderness to palpation in the suprapubic area, but no other abnormalities. A bimanual pelvic examination reveals a normal-sized uterus and adnexae with no apparent adnexal tenderness. No vaginal discharge is noted. The cervix appears normal.

What condition do you suspect the patient may have? What signs and symptoms support this diagnosis? What labs and diagnostic tests could help to confirm your suspected diagnosis?