Symptoms of a Urinary Tract Infection

Table of Contents
View All
Table of Contents

Anyone who has ever had a urinary tract infection (UTI) knows how frustrating and uncomfortable it can be. Even a mild case can cause pain when urinating, an increased urge to urinate, and blood or pus in the urine.

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.

lower UTI
© Verywell, 2018 

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 fever
  • Body chills
  • Rigors (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.

The main challenge in the very young and very old is that the classic signs are frequently either missing or misattributed to other causes.

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.

If your loved one is older, the main clues to watch out for are sudden changes in behavior and bladder control. These may be accompanied by lower abdominal pain or strong-smelling urine.

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.

Symptoms of urosepsis include:

  • 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)

If left untreated, sepsis can lead to septic shock, organ failure, and death.

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.

Recap

If you think you have symptoms of a UTI, see a doctor to get a diagnosis. Call 911 for any severe symptoms that might indicate sepsis, a life-threatening condition. These may include high fever, rapid heart rate, pale or blue skin tone, difficulty breathing, and severe pain.

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.

Frequently Asked Questions

  • What are the signs of a urinary tract infection during pregnancy?

    You may have no symptoms with a bacterial infection, or you may assume that signs like a backache or the need to urinate frequently are normal in pregnancy. Your healthcare provider should regularly screen your urine for bacteria so it can be treated. Between screenings, alert your healthcare provider if you notice other common UTI symptoms, such as fever, unusual urine odor, or burning or pain when you urinate. If you do have an infection, your healthcare provider can give you antibiotics that are safe for you and the baby.

  • What happens if you don’t treat a UTI?

    The infection may spread to the kidneys, blood, and other parts of your body. A condition called urosepsis, which is sepsis caused by a UTI, is also a risk. Sepsis occurs when an infection sets off a severe inflammatory response. It can potentially be deadly.

  • Can chest pain be caused by a urinary tract infection?

    Any type of severe infection can make it more likely to form blood clots, which can lead to serious coronary events that present as chest pains, such as a heart attack. However, it is very rare for someone to have a heart attack from a UTI.

Was this page helpful?
24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bono MJ, Reygaert WC. Urinary Tract Infection. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470195/

  2. National Collaborating Centre for Women's and Children's Health (UK). Urinary Tract Infection in Children: Diagnosis, Treatment and Long-term Management. London: RCOG Press. (NICE Clinical Guidelines, No. 54.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK50606/

  3. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment optionsNat Rev Microbiol. 2015;13(5):269–284. doi:10.1038/nrmicro3432

  4. Belyayeva M, Jeong JM. Acute Pyelonephritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519537/

  5. Najar MS, Saldanha CL, Banday KA. Approach to urinary tract infectionsIndian J Nephrol. 2009;19(4):129–139. doi:10.4103/0971-4065.59333

  6. Bremnor JD, Sadovsky R. Evaluation of dysuria in adults. Am Fam Physician. 2002;65(8):1589-96.

  7. Leslie SW, D'Andrea V, Sajjad H, et al. Nocturia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518987/

  8. Su RR, Palta M, Lim A, Wald ER. Pyuria as a Marker of Urinary Tract Infection in Neurogenic Bladder: Is It Reliable?. Pediatr Infect Dis J. 2019;38(8):804-807.

  9. Saleem MO, Hamawy K. Hematuria. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534213/

  10. Colgan R, Williams M, Johnson JR. Diagnosis and treatment of acute pyelonephritis in women. Am Fam Physician. 2011;84(5):519-26.

  11. Arshad M, Seed PC. Urinary tract infections in the infantClin Perinatol. 2015;42(1):17–vii. doi:10.1016/j.clp.2014.10.003

  12. Schlager TA. Urinary tract infections in children younger than 5 years of age: epidemiology, diagnosis, treatment, outcomes and prevention. Paediatr Drugs. 2001;3(3):219-27.

  13. Rowe TA, Juthani-Mehta M. Urinary tract infection in older adultsAging health. 2013;9(5):10.2217/ahe.13.38. doi:10.2217/ahe.13.38

  14. Nicolle LE; AMMI Canada Guidelines Committee*. Complicated urinary tract infection in adultsCan J Infect Dis Med Microbiol. 2005;16(6):349–360. doi:10.1155/2005/385768

  15. Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H. Urethral stricture: etiology, investigation and treatmentsDtsch Arztebl Int. 2013;110(13):220–226. doi:10.3238/arztebl.2013.0220

  16. Kalra OP, Raizada A. Approach to a patient with urosepsisJ Glob Infect Dis. 2009;1(1):57–63. doi:10.4103/0974-777X.52984

  17. Simonsen KA, Anderson-Berry AL, Delair SF, Davies HD. Early-onset neonatal sepsisClin Microbiol Rev. 2014;27(1):21–47. doi:10.1128/CMR.00031-13

  18. Garcia FJ, Nager AL. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics. 2002;109(5):846-51.

  19. George A, Goetz D. A case of sulfhemoglobinemia in a child with chronic constipation. Respir Med Case Rep. 2017;21:21-24.

  20. Mody L, Juthani-Mehta M. Urinary tract infections in older women: a clinical reviewJAMA. 2014;311(8):844–854. doi:10.1001/jama.2014.303

  21. Dason S, Dason JT, Kapoor A. Guidelines for the diagnosis and management of recurrent urinary tract infection in womenCan Urol Assoc J. 2011;5(5):316–322. doi:10.5489/cuaj.11214

  22. Kalinderi K, Delkos D, Kalinderis M, Athanasiadis A, Kalogiannidis I. Urinary tract infection during pregnancy: Current concepts on a common multifaceted problem. Journal of Obstetrics and Gynaecology. 2018;38(4):448-453. doi:10.1080/01443615.2017.1370579

  23. Sepsis Alliance. Urinary tract infections.

  24. Cowan LT, Lutsey PL, Pankow JS, Matsushita K, Ishigami J, Lakshminarayan K. Inpatient and outpatient infection as a trigger of cardiovascular disease: the ARIC study. J Am Heart Assoc. 2018;7(22). doi:10.1161/JAHA.118.009683

Additional Reading
  • Heppner, H.; Yapan, F.; and Wiedermann, A. "Urosepsis in Geriatric Patients." Aktuelle Urol. 2016;47(1):54-9. DOI: 10.1055/s-0041-106184.

  • Solomon, C. "Urinary Tract Infections in Older Men." N Engl J Med. 2016; 374:562-571. DOI: 10.1056/NEJMcp1503950.

  • Robinson, J.; Findlay, J.; Lang, M. et al. "Urinary tract infections in infants and children: Diagnosis and management." Paediatr Child Health. 2014; 19(6):315-19.
  • Schwartz, B. (2014) "Urinary Tract Infections." In: Levinson, W. eds. Review of Medical Microbiology and Immunology, 13e. New York, NY: McGraw-Hill Education.