3
Recognition
STEP 1: What are the Signs and Symptoms of UTIs?
➤ Warning signs:
• Presence of warning signs such as fever, rigors, acute delirium and/or unstable vital
signs suggest complicated cases with systemic infection/sepsis.
➤ Acute simple cystitis:
• Signs and symptoms localizing to the bladder (such as acute dysuria, suprapubic
tenderness, new or worsening incontinence, frequency, urgency or gross
hematuria).
➤ Pyelonephritis:
• Non localizing signs and symptoms (such as fever, rigors/chills, marked fatigue/
malaise, nausea or vomiting ) AND localizing signs and symptoms (such as
dysuria, suprapubic tenderness, back pain/costovertebral angle tenderness, pelvic
or perineal pain in men, new or worsening incontinence, frequency, urgency or
gross hematuria).
Notes:
1. Pyelonephritis may present without symptoms of cystitis.
2. Pelvic or perineal pain in men can suggest accompanying prostatitis.
➤ Catheter-associated urinary tract infection:
• If catheter is still present:
▶ Systemic or non-specific signs and symptoms, such as fever, rigor/chills or
new onset clear cut delirium with no other identified cause, OR signs and
symptoms localizing to genitourinary tract (such as suprapubic tenderness or
costovertebral angle tenderness), OR acute pain, swelling or tenderness of the
testes, epididymis or prostate in men.
• If catheter was removed in the previous 48 hours:
▶ Signs and symptoms that localize to the genito-urinary tract, such as urgency,
frequency, dysuria, gross hematuria, suprapubic tenderness or costovertebral
angle tenderness.
Note: Presence of acute pain, swelling or tenderness of the testes, epididymis and/or
prostate in males with UTI should trigger evaluation for possible complications such
as epididymitis, epididymo-orchitis, and/or prostatitis.
