Clinical features of UTI

UTIs can involve any part of the urinary tract.

General features of a UTI include: (1)

• dysuria, frequency, urgency and a sensation of incomplete bladder emptying - a very common presentation
• lower abdominal pain - often a presentation in children and young adults
• sudden development of incontinence - often a presentation in the elderly
• haematuria
• enuresis occurring in a previously 'dry' child
• non-specifically unwell if previously fit - presentation is seen in infants and elderly

Symptoms and signs of lower UTI include:

• dysuria
• urgency
• frequency
• suprapubic tenderness
• strangury (a condition marked by slow, painful urination, caused by muscular spasms of the urethra and bladder)
• flank or back pain
• haematuria
• a change in the smell of urine

Three or more symptoms should be present to make a diagnosis of UTI. When both dysuria and frequency are present the probability of an UTI is >90%.

Symptoms of upper UTI include:

• loin pain
• flank tenderness
• fever
• rigors
• other manifestations of systemic inflammatory response

Upper UTI symptoms develops rapidly and if accompanied by bacteraemia may be a life threatening condition

1. Public Health England guidance. Urinary tract infection: diagnostic tools for primary care. Last updated May 2024