Signs & Symptoms of UTI
What are the Symptoms of UTI?
Urinary tract infection can present with a variety of signs and symptoms. Some of these are common features seen in any urinary infection whereas the others are specific to the site of infection. The symptoms and signs are:
1. Fever with chills are not common but can occasionally occur with complicated UTI and can be associated with difficulty in passing urine (dysuria). High-grade fevers can be a sign of severe infection.
2. Burning urination occurs as the mucosa of the urethra is inflamed. The urine can be turbid or cloudy and foul smelling. Some people may pass pink, reddish or cola colored urine which is bloodstained. Tip of the urethra shows yellowish sticky discharge. These symptoms are not specific to infection and can occur with other conditions including cancer. A thorough urological evaluation should be performed.
3. Pain in the abdomen, flanks or the suprapubic region. This pain can be pelvic or rectal in men when associated with prostatitis. Rectal examination elicits tenderness in prostatitis. Women can have pelvic pain. In case of kidney infection (Pyelonephritis), there is pain and tenderness over the upper back and flanks; this is usually associated with high fever with chills, and can be associated with nausea and vomiting. Abdominal and pelvic pain may be caused by many other serious health conditions – medical evaluation is advised.
4. There is also increased urinary frequency both during the day and night (nocturia). This results in passage of a small quantity of urine each time at short intervals. A persistent desire to pass urine is called urgency. Other causes of frequent urination include urinary tract obstruction such as urethral stricture or urinary retention.
5. The urinary stream can be slow and there may be terminal dribbling of urine as swelling results in a narrowing of the urethra. One may need to strain to pass urine when infection is severe. The urinary stream may become intermittent as it stops and starts. Urinary obstruction and retention, especially in men, can occur.
6. A sensation of incomplete emptying of bladder occurs due to irritation of bladder trigone and neck area by the inflammatory exudate.
7. Mental changes like confusion may be seen in the elderly people with UTI. Fatigue and general malaise can be seen.
8. In men with associated orchitis, epididymitis or epididymo-orchitis, the scrotum may be swollen and painful. The testes and epididymis are tender to touch. In these people, the pain is aggravated on walking, so they require scrotal support for pain relief.
9. Small children may present with fever and vomiting.
10. Inability to hold urine or incontinence may occur especially in women. In men with enlarged prostate, overflow incontinence may occur as there is obstruction to the outflow of urine from the bladder which fills up to its capacity, causing the urine to overflow.
11. Dyspareunia or painful sexual intercourse occurs in women with lower urinary tract infection.
12. If an abscess forms due to collection of pus in (pyonephrosis) or around kidney (perinephric abscess), there may be fever, severe pain and a lump is seen over the flank.
13. Pneumaturia or passage of air bubbles in urine is a very serious condition and may occur in people with diabetes. A life-threatening kidney infection called Emphysematous pyelonephritis may occur and is associated with high fever, vomiting and flank pain.
1. Hiep T. Nguyen. Bacterial infections of the urinary tract. Smith’s General Urology 17th ed. 2008;193-218
2. Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis . 2010 Mar 1;50(5):625-63.
3. Liza Genao, Gwendolen T. Buhr. Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities. Ann Longterm Care. 2012 April; 20(4): 33–38.
4. Leonie GM Giesen, Gráinne Cousins, Borislav D Dimitrov, Floris A van de Laar, Tom Fahey. Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs. BMC Fam Pract. 2010; 11: 78.