Urinary tract infection

Alternative Names

Symptoms

The symptoms of a UTI include:

• Cloudy urine
• Blood in the urine
• Foul or strong urine odor
• Frequent or urgent need to urinate
• Need to urinate at night
• Pain or burning with urination
• Pressure in the lower pelvis

Young children with UTIs may only have a fever, or no symptoms at all.

• Mental changes or confusion (in the elderly, mental changes or confusion often are the only signs of a urinary tract infection; possible spread to the blood should be considered)
• Flank (side) pain, vomiting, fever, and chills (may be a sign of kidney involvement)
• Painful sexual intercourse
• Penis pain

Exams and Tests

Tests generally include taking a urine sample.

Urinalysis commonly reveals nitrates, white blood cells, and red blood cells. See also: RBC - urine

A urine culture (clean catch) or catheterized urine specimen may be done to determine the type of bacteria in the urine and the appropriate antibiotic for treatment.

TESTING IN CHILDREN

Many children with cystitis need special imaging studies to determine why they got a urinary tract infection. Many of them have something abnormal about their anatomy that predispose them to infections. The long-term consequences of repeated urinary tract infections in children can be quite serious. However, these infections can usually be prevented.

Special studies usually include an ultrasound of the kidneys and an x-ray taken during urination (called a voiding cystourethrogram or VCUG).

Most experts recommend this evaluation for:

• Girls over age 5 who have had two or more urinary tract infections
• All boys with their first urinary tract infection
• All children who have a fever along with their urinary tract infection
• All children under age 5 with their first urinary tract infection

References

Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for medical management of first urinary tract infection in children 12 years of age or less. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006 Nov. 23 p.

Walsh, PC, ed. Campbell’s Urology. 8th ed. Philadelphia, Pa: Saunders; 2002.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.