26th June 2023

Presentation

A lower urinary tract infection (UTI) is an infection of the bladder typically caused by bacteria from the gastrointestinal tract.

Lower UTIs can present with increased urinary frequency, nocturia, urgency, dysuria, suprapubic pain, foul-smelling urine, or haematuria. In the elderly or those with cognitive impairment, UTIs may present with non-specific features such as delirium, anorexia, nausea, and vomiting.

A lower UTI can be complicated by persistent infection, treatment failure or recurrent infection. The risk factors for complications include structural or neurological abnormalities of the urinary tract, external sources of infection such as catheters and immunosuppressive comorbidities such as diabetes. A further complication is the spread of infection to the upper urinary tract giving rise to pyelonephritis. This presents with fever, rigors, and loin pain with renal angle tenderness on examination.