A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment?
a. Uncomplicated lower urinary tract infection treatable with short-course therapy
b. Complicated lower urinary tract infection treatable with single-dose therapy
c. Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics
d. Complicated upper urinary tract infection requiring parenteral antibiotics
ANS: A
These are symptoms of uncomplicated cystitis, which is a lower urinary tract infection that can be treated with a short course of antibiotics. Short-course therapy is more effective than single-dose therapy and is preferred. A complicated lower urinary tract infection would be associated with some predisposing factor, such as renal calculi, an obstruction to the flow of urine, or an indwelling catheter. Upper urinary tract infections often include severe flank pain, fever, and chills.
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