Urinary Tract Infection

A urinary tract infection is a bacterial infection of the bladder, urethra or kidneys. Most are simple bladder infections that settle quickly, but an infection reaching the kidney can make a patient seriously unwell within hours.

Symptoms

Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.

• Burning or pain on passing urine
• Passing small amounts of urine frequently and urgently
• Cloudy, strong-smelling or blood-stained urine
• Lower abdominal discomfort or pressure
• Fever with chills and loin pain when the kidney is involved
• Confusion or a fall as the presenting sign in an elderly patient

When to see a doctor

• Fever with loin pain and vomiting — this needs same-day assessment
• Symptoms in a man, in pregnancy, in a child, or in a diabetic patient
• Infections that keep returning after treatment
• Blood in the urine that persists after the infection has been treated

Tests that may be advised

Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.

• Urine routine examination and microscopy
• Urine culture and sensitivity before starting antibiotics where possible
• Blood count and kidney function in unwell patients
• Ultrasound of the kidneys, ureters and bladder for recurrent or complicated infection
• Blood sugar testing, since undiagnosed diabetes often surfaces this way

How it is treated

Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.

• An appropriate antibiotic course completed in full, guided by culture where available
• Generous fluid intake and regular, complete bladder emptying
• Intravenous antibiotics and admission for kidney infection or sepsis
• Investigation and correction of an underlying cause — stones, obstruction, prostate enlargement, poor sugar control
• Preventive advice for recurrent infection, including hygiene and post-intercourse voiding