A urinary tract infection (UTI) is a common bacterial infection that can affect any part of the urinary system, including the kidneys, ureters, bladder, and urethra. While many UTIs are mild and treatable with antibiotics, some can progress to a severe stage, requiring immediate medical attention. Recognizing signs of a serious UTI is important for timely intervention.
Common Urinary Tract Infection Symptoms
Lower urinary tract infections, affecting the bladder and urethra, present with noticeable symptoms. These include a frequent, strong urge to urinate, even if only a small amount is passed. Urination may cause pain or a burning sensation (dysuria). Urine may appear cloudy, have an unusually strong odor, or contain visible blood. There may also be dull pain or pressure in the lower abdomen or pelvic area.
Emergency Symptoms Requiring Immediate Care
When a UTI escalates to a more severe infection, such as a kidney infection (pyelonephritis) or sepsis, emergency care is needed. A high fever, above 101°F (38.3°C), is a warning sign, often with chills. Severe pain in the back or flank area, just under the ribs, suggests the infection has reached the kidneys. Nausea and vomiting are common with kidney infections, and persistent vomiting can lead to dehydration.
Other concerning symptoms include confusion or disorientation, particularly in older adults, who may not exhibit typical fever symptoms. General weakness or lethargy can also signal a more serious infection. If the infection has entered the bloodstream, symptoms can include a rapid heart rate, low blood pressure (systolic blood pressure below 100 mmHg), and difficulty breathing. Any of these severe symptoms warrant an immediate emergency room visit.
Risk Factors for Severe UTIs
Certain individuals face an increased risk of developing severe UTIs or complications. Pregnant individuals are at a higher risk. People with diabetes or weakened immune systems are also more susceptible to complicated infections.
Conditions that obstruct urine flow, such as kidney stones, an enlarged prostate, or structural abnormalities, increase the likelihood of severe UTIs. Recent urinary tract surgery or the use of a urinary catheter also elevate the risk. Young children (under two years old) and older adults (over 60 years old) are more prone to severe infections and may present with atypical symptoms.
Potential Complications of Untreated UTIs
Leaving a severe UTI untreated can lead to serious health issues. Progression to pyelonephritis, a kidney infection, can cause permanent kidney damage and scarring. This damage may contribute to chronic kidney disease or high blood pressure.
Untreated UTIs can also recur. The most life-threatening complication is sepsis, also known as urosepsis when it originates from the urinary tract. Sepsis is the body’s severe response to an infection, where the immune system attacks its own tissues and organs, potentially leading to organ failure and septic shock.
What Happens During an ER Visit
Upon arriving at the emergency room for a suspected severe UTI, staff will take a medical history and perform a physical examination. A urine sample is collected for a urinalysis, confirming a UTI. A urine culture may also be performed to identify the specific bacteria and determine the most effective antibiotic.
Blood tests are conducted to assess for signs of infection spreading to the bloodstream (sepsis) and to check organ function. Imaging tests like a CT scan or ultrasound may be used to examine the kidneys and urinary tract for blockages or other issues. Initial treatment involves administering antibiotics, often intravenously (IV) for faster action in severe cases, along with IV fluids for dehydration and pain management medications.