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A urinary tract infection (UTI) is an infection of the urinary tract. An infection anywhere from the kidneys to the ureters to the bladder to the urethra qualifies as a urinary tract infection.

Symptoms & Signs


  • Urethritis: discomfort or pain at the urethral meatus or a burning sensation throughout the urethra with micturition (dysuria).
  • Cystitis: pain in the midline suprapubic region and/or frequent urination
  • Hematuria (bloody urine)
  • cloudy and foul-smelling urine
  • High temperature lasting for more than 3 days should be a trigger to get the urine culture done to ascertain whether the fever is due to UTI or not. UTI is very harmful especially in infants since it can cause permanent renal damage.
  • Nausea and vomitting, accompanied by high fever may indicate a more complicated UTI in which the kidney is infected
  • Some urinary tract infections are asymptomatic.
  • Increased confusion and associated falls are common presentations to Emergency Departments for elderly patients with UTI.

Diagnosis


A patient with dysuria (painful voiding) and urinary frequency generally has a spot mid-stream urine sample sent for urinalysis, specifically the presence of nitrites, leukocytes or leukocyte esterase. If there is a high bacterial load without the presence of leukocytes, it is most likely due to contamination. Pyelonephritis is ruled out by checking for costovertebral angle tenderness (CVAT). The diagnosis of UTI is confirmed by a urine culture.

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