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Clinical features of UTI

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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UTIs can involve any part of the urinary tract.

General features of a UTI include: (1)

  • dysuria, frequency, urgency and a sensation of incomplete bladder emptying - a very common presentation
  • lower abdominal pain - often a presentation in children and young adults
  • sudden development of incontinence - often a presentation in the elderly
  • haematuria
  • enuresis occurring in a previously 'dry' child
  • non-specifically unwell if previously fit - presentation is seen in infants and elderly

Symptoms and signs of lower UTI include:

  • dysuria
  • urgency
  • frequency
  • suprapubic tenderness
  • strangury (a condition marked by slow, painful urination, caused by muscular spasms of the urethra and bladder)
  • flank or back pain
  • haematuria
  • a change in the smell of urine

Three or more symptoms should be present to make a diagnosis of UTI. When both dysuria and frequency are present the probability of an UTI is >90%.

Symptoms of upper UTI include:

  • loin pain
  • flank tenderness
  • fever
  • rigors
  • other manifestations of systemic inflammatory response

Upper UTI symptoms develops rapidly and if accompanied by bacteraemia may be a life threatening condition


1. Public Health England guidance. Urinary tract infection: diagnostic tools for primary care. Last updated May 2024

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