If the infection moves from the bladder to the kidneys, the condition can get worse. It can trigger severe back pain, nausea, vomiting, and, in rare cases, kidney damage.
And, it’s not just adults who can be affected. Newborns and children can also get UTIs. Those occurring in the elderly can sometimes be life-threatening.
By knowing the signs and symptoms of a UTI, you can seek treatment and avoid many complications of this all-too-common infection.
This article discusses UTI symptoms, signs of complications, and when to see a doctor.
Frequent Symptoms
The symptoms of a urinary tract infection are largely defined by their location in the urinary system. There are two types of UTI:
A lower urinary tract infection occurs in the bladder or urethra (the tube through which urine exits the body). It is commonly referred to as a bladder infection. An upper urinary tract infection involves the kidneys and ureter (the duct through which urine passes from the kidneys to the bladder). An infection of the kidneys is also referred to as pyelonephritis.
Lower Urinary Tract (Bladder Infection)
A lower urinary tract infection typically occurs when bacteria enter the urethra and cause an infection in the bladder.
When symptoms appear, they often start with a dull ache or discomfort in the pelvis or urethra. Usually, within hours, the UTI will have characteristic symptoms, including:
Pain or burning during urination (dysuria) An increased urge to urinate (urinary urgency) The need to get up at night to urinate (nocturia) Inability to hold your urine (urinary incontinence) Passing frequent, small amounts of urine Foul-smelling urine Cloudy urine (pyuria) Bloody urine (hematuria) Lower abdominal or pelvic pain Fever Fatigue
Upper Urinary Tract (Pyelonephritis)
A bladder infection that has moved to the kidneys is usually considered serious and in need of urgent medical care. Pyelonephritis can cause systemic (all-body) symptoms that are not only more apparent but frequently debilitating.
Signs of pyelonephritis may include:
Flank pain (pain that’s usually deep and high in the back or sides, though it can be present in the upper abdomen)High feverBody chillsRigors (shivering and sweating accompanied by a rise in temperature)Nausea or vomiting
Special Populations
Babies, young children, and the elderly are also commonly affected by UTIs and often in vastly different ways.
With newborns, the only clues may be persistent fussiness or crying accompanied by odd-smelling urine and refusing to eat. It’s important to discuss your baby’s bowel and urinary habits at every doctor visit, however mild or incidental the changes may seem.
In contrast, the signs of a UTI in toddlers and younger children will be more characteristic. They may include pain or burning with urination, urinary urgency, daytime incontinence (enuresis), or the rubbing or grabbing of the genitals.
A UTI in the elderly may not present with traditional symptoms seen in other adults. These may include urinary incontinence, a change in behavior, and mental confusion.
Complications
UTI complications often occur as a result of an untreated or undertreated infection. The risk is also high in people with underlying kidney disorders, diabetes, or diseases affecting the immune system (such as HIV).
Complications of a urinary tract infection include:
Recurrent UTIs occurring at least twice in six months or four times in a year, most commonly in women Bladder dysfunction and/or overactive bladder from damage or scarring to the bladder from recurrent infections Urethral narrowing (stricture) in men with recurrent infections Increased risk of preterm birth and low birth weight in pregnancy Permanent kidney damage Sepsis (a potentially life-threatening, whole-body inflammatory response caused by severe infection)
In Children
A urinary tract infection in newborns will often have few, if any, of the classic signs of a UTI. A child may only become symptomatic when sepsis (also referred to as urosepsis) develops. Sepsis is always considered a medical emergency.
Go to an emergency room or call 911 if your baby develops some or all of the following symptoms:
Yellowing of the eyes and skin (jaundice) High fever Decreased tone (floppiness) Vomiting Cloudy or bloody urine Irregular breathing Pale pallor or even a bluish skin tone (cyanosis) A bulging of the soft spot on the back of the head triggered by the development of meningitis
In the Elderly
UTIs are frequently missed in the elderly. The infection may only become apparent when urosepsis starts to affect the brain and other vital organs.
If left untreated, sepsis can lead to septic shock, organ failure, and death.
An abnormally rapid heart rate (tachycardia) High fever or hypothermia (body temperatures below 95 degrees) Difficulty breathing or shortness of breath (dyspnea) Profuse sweating Sudden extreme anxiety Severe back, abdominal, or pelvic pain Dementia-like symptoms triggered by the development of brain inflammation (encephalitis)
When to See a Healthcare Provider
Mild UTIs in healthy adults will often go away on their own without treatment. However, you shouldn’t avoid seeing a healthcare provider to get a urine test or start treatment.
If you develop signs of a kidney infection, including flank pain, nausea, or vomiting, see a healthcare provider immediately.
If you’re pregnant, never take a chance with UTIs, especially if you have diabetes, HIV, or have had previous infections. Even mild symptoms should be looked at, treated, and monitored to ensure that the infection is fully cleared.
Without exception, any symptoms suggestive of sepsis should be treated as a medical emergency. This is especially true in babies and the elderly.
Summary
A lower urinary tract infection, known as a bladder infection, affects the bladder and urethra. An upper urinary tract infection, or kidney infection, can cause symptoms that affect the whole body. Babies and the elderly can have UTIs, but they may not show the classic symptoms.
If you suspect a UTI, contact your doctor for a diagnosis. Call 911 for any signs of sepsis, a whole-body inflammatory response that can be life-threatening.
