Acute cystitis is a common and costly condition in women1,2 that decreases quality of life.3 Many of the 8 million annual office visits for cystitis in the United States may be averted if low-risk women with unequivocal symptoms could be managed safely over the telephone4,5 by specially trained nurses. Uncomplicated cystitis is amenable to such management because its diagnosis is based principally on a patient's history. In the absence of vaginal complaints, certain combinations of voiding symptoms increase the probability of urinary tract infection (UTI) to over 90%.4,6 Accordingly, laboratory evaluation in most cases of simple cystitis appears to be unnecessary.1 Urinalysis has been found not to be cost-effective in the diagnosis of cystitis7,8 and has been eliminated from various practice guidelines.9- 11
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The Rational Clinical Examination
Several types of UTI are described by their location: urethritis, cystitis, pyelonephritis, and...
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