Symptoms of a UTI
The symptoms seen in UTI are variable, and in younger
adults, they can vary from mild discomfort to passing urine
that is bloodstained and accompanied by back or loin pain
and shivers (rigours). In older people, there may be offensive
urine that is worsening, new incontinence, and often
confusion (this is termed as ‘delirium’ by NICE, 2013) or
being ‘off legs’ (a sudden deterioration in mobility). Falls
that cannot be attributed to other factors should prompt an
investigation into fluid intake and urine output, including
assessment of vital signs and the use of a urinary dipstick.
When the results of these investigations are negative, other
causes should be considered, such as neurological or cardiac
events, and the tests should be followed up (NICE,
2014a; 2014b). Additional symptoms can include frequency;
urgency; and/or strangury (the feeling of needing to pass
urine despite having just done so); dysuria (pain or discomfort
on passing urine); urine that is offensive smelling,
cloudy, or contains blood; lower abdominal aches or pains;
and aching sometimes accompanied with nausea, fatigue,
and sweats. Older frail women (with or without catheters)
may not have these features and can present with aching
ribs, rigours, more confusion, and a slightly increased temperature,
for example, 37.90° C or more than 1.50° C above
their normal temperature (NICE, 2014a; 2014b).