A 28 year young female Katrina present to your OPD with complaints of suprapubic pain, urinary frequency and dysuria. She also passed blood in last voided urine about 30 minutes ago. Her urinanalysis demonstrate the presence of pyuria but no white cell casts. On physical examination, she has suprapubic tenderness on palpation. Which of the following is the likely diagnosis in this patient?

The clinical presentation of the patient in the stem of the question is of cystitis, which is characterized by pyuria and hematuria but absence of white cell casts in the urine. Patients with acute pyelonephritis present with fever, leucocytosis, flank tenderness, urinary white cells, and white cell casts in the urine. Chronic pyelonephritis is almost always the result of chronic urinary tract obstruction and repeated bouts of acute inflammation in the kidneys. Also know: Bacterial cystitis is common, paicularly in women. The most common etiologic agents are coliform bacteria. Hemorrhagic cystitis may occur in patients receiving cytotoxic anti-tumor drugs, such as cyclophosphamide, and sometimes complicates adenovirus infection Interstitial cystitis causes a chronic pelvic pain syndrome, typically in women. It is characterized by suprapubic pain that increases with bladder filling and is relieved by bladder emptying, leading to very frequent urination during both day and night