Signs and symptoms of urinary tract infections

General UTI symptoms

Lower urinary tract infections (bladder, urethra) symptoms

• Painful and or/ difficult urination (often accompanied by a burning or stinging sensation)
• A frequent need to urinate (sometimes despite not having a full bladder and passing a very small amount of fluid)
• A sensation of having a full bladder (although the organ may not be full at all)
• Dark, cloudy urine or urine that contains blood
• Foul smelling urine
• A low fever (38 degrees Celsius / 101 degrees Fahrenheit or lower)
• A cramping sensation (pressure) in the lower abdomen and / or groin
• Fatigue / tiredness

Upper urinary tract infections (kidneys, ureters)symptoms

• Pain (this can be severe) in the flank area (below the ribs on the back) or lower back
• Nausea and vomiting
• A high fever (38 degrees Celsius / 101 degrees Fahrenheit and higher)
• Night sweats and the chills
• An altered mental state (i.e. memory difficulties, confusion, disorientation, poor regulation of emotions, perception and judgement disruptions etc.)

UTI Signs and symptoms as they relate to age and gender

Along with general signs and symptoms, other things to look out for or keep in mind as they relate to a person’s age or gender include…

1. Paediatric UTIs

• Fever (originating unexpectedly and appearing to have an unknown cause)
• Changes in urine colour (urine may be cloudy or dark) and smell (giving off a foul or 'strong' smell)
• Crying (young children, particularly infants may cry when urinating, indicating discomfort or pain)
• Changes in appetite or loss of appetite (young children in particular may have a poor appetite, slowed weight gain or lack of interest in feeding)
• General fussiness, irritability and malaise (especially if a child is younger than the age of 2)
• Vomiting and or / diarrhoea (or loose bowel movements)
• Abdominal pain
• Urination accidents – incontinence or enuresis / involuntary urination (older children may experience wetting themselves even though they are sufficiently toilet trained)
• Jaundice (more common in infants aged between 0 and 2 months)

2. UTIs in adult women

• Women of reproductive age: Vaginitis or inflammation of the vagina – itching and pain, accompanied by abnormal discharge – this is more common in adolescent females, and or/ young women who are sexually active (and who are at a high risk for STIs / sexually transmitted infections – especially if there are multiple partners). Blood in the urine is fairly common among young women and may indicate haemorrhagic cystitis. Vaginal discharge may also indicate inflammation of the cervix (cervicitis) or pelvic inflammatory disease (PID) and will be differentiated from UTI indicators during a medical evaluation (especially if a female has a history of occurrences).
• Pregnant women: Symptoms affecting the lower urinary tract can easily progress to the kidneys, causing more severe symptoms. Pregnant women may or may not be periodically tested during prenatal medical visits as a way to catch any symptoms of infection before they reach the kidneys, and thereby prevent any unwanted complications affecting both the mother and unborn baby. Excessive urination (i.e. increased frequency) at night is common among pregnant women and does not always indicate a UTI specifically – in general this is merely an indication of a growing uterus / foetus in the womb, increased volume of blood, as well as increased renal blood flow and glomerular filtration rates (i.e. the volume of fluid that is filtered through the kidneys).
• Senior women: Fatigue, shakiness, muscle aches and weakness, delerium as well as abdominal pain are common symptoms.

From time to time women may experience a similar set of general UTI symptoms when there is no actual infection present. An irritant can sometimes lead to similar symptoms but this typically clears up once the offending substance is removed. Irritants can include general everyday products such as soaps or oils commonly used in the bath or shower, or these symptoms may occur as a side-effect of certain medications.

3. UTIs in adult men

• Urinary dribbling and a slow stream of urine
• Prostatic enlargement
• Anatomic abnormalities (more prevalent in younger males) or ureteral obstructions / stricture
• Urethritis / prostatitis / epididymitis conditions which lead to UTIs

When to see a doctor if you suspect a UTI

Any symptoms of a UTI should be evaluated by a medical doctor as soon as possible, and especially if pain is severe. Children should be seen by a medical doctor within 24 hours, as more severe infections can quickly escalate and cause further complications. Younger children in particular are at high risk of kidney infection and associated complications if not treated timeously.

Pain that is noted around the lower flank, abdomen or back, must be attended to as soon as possible as this could indicate an infection of the kidney/s.