A 45-year-old female with a history of multiple sclerosis presents with increased urinary frequency, urgency, and lower abdominal discomfort. She has a fever and her urinalysis shows pyuria. What is the likely diagnosis, and how should this be managed?
This patient likely has cystitis. It's important to recognize that patients with neurological diseases like multiple sclerosis are at higher risk for UTIs due to possible urinary retention from neurogenic bladder. The management would involve antibiotic therapy based on local resistance patterns, and a discussion about strategies to minimize future UTIs, such as clean intermittent catheterization or medication to manage neurogenic bladder.