Clinical Pearls

The most common cause of cystitis is Escherichia coli.

Bacteriuria caused by group B streptococcus in pregnancy necessitates the use of intravenous penicillin or ampicillin in labor to decrease the risk of neonatal group B streptococcus sepsis.

Pyelonephritis presents with Hank tenderness and fever.

Urethritis, commonly caused by Chlamydia or gonococcus, should be suspected with negative urine cultures and symptoms of a urinary tract infection.

REFERENCES

Stenchever MA. Urogynecology. In: Stenehever MA, Droegcmueller W. Herbst AL. Mishell DR. eds. Comprehensive gynecology, 4th ed. St. Louis: Mosby-Year Book. 2001:607-640. Bhatia NN. Genitourinary dysfunction: pelvic organ prolapse, urinary incontinence, and infections. In: Hacker NF. Moore JG. Gambone JC, eds. Essentials of obstetrics and gynecology. 4th ed. Philadelphia: Saunders, 2004:309-324.

A 22-year-old nulliparous woman, whose last menstrual period was approximately 2 weeks ago, states that she had unprotected intercourse last night. She asks whether anything can be done to prevent her from getting pregnant. She usually uses a condom and foam for contraception. She is in good health. Her blood pressure is 120/70, heart rate 80 bpm, and temperature 99°F. Heart and lung examinations are normal. The abdomen is nontender and without masses. Pelvic examination reveals a normal anteverted uterus. There are no adnexal masses. The pregnancy test is negative.

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