What is the Difference Between Cystitis and Pyelonephritis?

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Cystitis and pyelonephritis are both urinary tract infections (UTIs), but they affect different parts of the urinary system and have distinct characteristics. The main differences between cystitis and pyelonephritis include:

  1. Location: Cystitis is an inflammation of the lower urinary tract, specifically the bladder and urethra, while pyelonephritis is an inflammation of the upper urinary tract, including the ureters, renal pelvis, and kidney.
  2. Symptoms: Cystitis typically presents with symptoms such as frequent urination, painful urination, and lower abdominal pain. Pyelonephritis, on the other hand, starts with general symptoms like fever, chills, and nausea, followed by flank pain, costovertebral angle tenderness, and vomiting.
  3. Severity: Cystitis is generally a less severe inflammatory infection compared to pyelonephritis, which is a relatively severe infection.
  4. Diagnosis: Both conditions require a urine culture to confirm diagnosis, but additional tests for pyelonephritis may include a blood urea test, complete blood count (CBC), and fasting blood sugar (FBS).
  5. Treatment: Cystitis is typically treated with oral antibiotics like Quinolones (norfloxacin and ciprofloxacin) and Co-amoxiclavs. Pyelonephritis, due to its severity, is more commonly treated with intravenous antibiotics. The duration of treatment also varies, with cystitis often requiring 3 to 5 days of treatment and pyelonephritis requiring 7 to 14 days.

Comparative Table: Cystitis vs Pyelonephritis

Here is a table comparing the differences between cystitis and pyelonephritis:

Feature Cystitis Pyelonephritis
Definition Inflammation of the bladder Inflammation of the upper urinary tract, including the ureters, renal pelvis, and kidney
Type of Urinary Infection Lower urinary tract infection Upper urinary tract infection
Severity Less severe More severe
Causative Agents Bacteria such as E. coli Bacteria that travel from the lower urinary tract
Common Symptoms Dysuria, pyuria, hematuria, and bladder pain Fever, back pain, nausea or vomiting, and gross hematuria (more common in women)
Diagnosis Urine culture Additional tests such as blood urea test, CBC, and FBS
Treatment Method Oral antibiotics (e.g., Quinolones, Co-amoxiclavs) Intravenous antibiotics

Cystitis is an inflammation of the bladder, typically caused by bacterial infections such as E. coli, and is considered a lower urinary tract infection. Symptoms of cystitis include dysuria, pyuria, hematuria, and bladder pain. On the other hand, pyelonephritis is an upper urinary tract infection that affects the ureters, renal pelvis, and kidney. It is caused by bacteria traveling from the lower urinary tract and is generally more severe than cystitis. Symptoms of pyelonephritis include fever, back pain, nausea or vomiting, and gross hematuria (more common in women). While both conditions require a urine detailed report to confirm their diagnosis, pyelonephritis may also require additional tests such as a blood urea test, complete blood count (CBC), and fasting blood sugar (FBS). Treatment for cystitis typically involves oral antibiotics like Quinolones and Co-amoxiclavs, whereas pyelonephritis patients are more commonly prescribed intravenous antibiotics.