Cystitis of viral etiology in children from the point of view of a urologist

The development of Russian clinical guidelines for the treatment of children with recurrent urinary tract infection and cystitis was almost completed by 2019. But the high level of complications of viral and infectious nature during the coronavirus pandemic has made significant adjustments to the diagnostic and therapeutic complex of management of such patients. Clinical recommendations are presented for urinary tract infections in children, which include both cystitis and pyelonephritis. Exclusively for cystitis, there are only clinical recommendations “Cystitis in women”. Cystitis is classified according to various signs: etiology, course, primary lesion and complicated forms. In determining acute cystitis in clinical recommendations for urinary tract infection in children, the bacterial origin of inflammation is indicated. It is assumed that the most common causative agents of cystitis are E. coli and other representatives of the intestinal group. In the practice of a pediatric urologist, there are observations when patients with complaints characteristic of cystitis are treated against or after viral infections (respiratory viral, and in recent years, including against the background of a new coronavirus infection). At the same time, with a few exceptions, normal results of urine tests are revealed in patients, and in observations when the diagnostic process comes to cystoscopy, hyperemia and hyperplasia of the epithelium, not characteristic of the bacterial etiology of cystitis, is detected on the mucosa (usually in the lower part of the Lieto triangle and in the neck of the bladder). Taking into account the peculiarities of the structure of the bladder wall in children, we consider it important to understand the etiology of cystitis. The article describes the features of cystitis caused by various viruses: herpes simplex virus, cytomegalovirus, papillomavirus infection, polyomavirus and coronavirus. For the final revision of clinical recommendations for the treatment of children with cystitis and the prevention of complications from the upper urinary tract in bacterial, viral and other infectious diseases, the experience of urologists and surgeons should be analyzed.