Some pain above the pubic bone or in the lower back may be present. People experiencing an upper urinary tract infection, or pyelonephritis, may experience flank pain, fever, or nausea and vomiting in addition to the classic symptoms of a lower urinary tract infection. Rarely, the urine may appear bloody or contain visible pus in the urine.UTIs have been associated with onset or worsening of delirium, dementia, and neuropsychiatric disorders such as depression and psychosis. The reasons for this are unknown, but may involve a UTI-mediated systemic inflammatory response which affects the brain. Cytokines produced as part of the inflammatory response may produce neuroinflammation, in turn affecting dopaminergic and/or glutamatergic neurotransmission as well as brain glucose metabolism. Children
In young children, the only symptom of a urinary tract infection (UTI) may be a fever. Because of the lack of more obvious symptoms, when females under the age of two or uncircumcised males less than a year exhibit a fever, a culture of the urine is recommended by many medical associations. Infants may feed poorly, vomit, sleep more, or show signs of jaundice. In older children, new onset urinary incontinence (loss of bladder control) may occur. About 1 in 400 infants of 1 to 3 months of age with a UTI also have bacterial meningitis. Elderly
Urinary tract symptoms are frequently lacking in the elderly.
They may benefit from self-treatment upon occurrence of symptoms with medical follow-up only if the initial treatment fails. Complicated
Complicated UTIs are more difficult to treat and usually requires more aggressive evaluation, treatment and follow-up. It may require identifying and addressing the underlying complication. Increasing antibiotic resistance is causing concern about the future of treating those with complicated and recurrent UTI. Pyelonephritis
Pyelonephritis is treated more aggressively than a simple bladder infection using either a longer course of oral antibiotics or intravenous antibiotics. Seven days of the oral fluoroquinolone ciprofloxacin is typically used in areas where the resistance rate is less than 10%. If the local resistance rates are greater than 10%, a dose of intravenous ceftriaxone is often prescribed. Trimethoprim/sulfamethoxazole or amoxicillin/clavulanate orally for 14 days is another reasonable option. In those who exhibit more severe symptoms, admission to a hospital for ongoing antibiotics may be needed. Complications such as ureteral obstruction from a kidney stone may be considered if symptoms do not improve following two or three days of treatment. Prognosis
With treatment, symptoms generally improve within 36 hours. Up to 42% of uncomplicated infections may resolve on their own within a few days or weeks.Some children will develop recurrent urinary tract infection. When urinary tract infection involves the lower urinary tract, it develop cystitis, if urinary tract infection involves the upper tract, pyelonephritis develops. About 10 to 20% of pyelonephritis will go on and develop scarring of the affected kidney.