A urinary tract infection, or UTI, is usually treatable. Burning while passing urine, frequent urination, lower abdominal discomfort and cloudy or strong-smelling urine are common symptoms. Most infections remain limited to the bladder and improve with appropriate treatment.
The problem starts when the infection moves beyond the bladder. In some cases, bacteria can travel up to the kidneys and then enter the bloodstream. This can lead to sepsis, a serious reaction to an infection that can cause damage to vital organs.
A UTI does not automatically lead to sepsis. However, ignoring a worsening infection or delaying treatment when symptoms are severe can increase the risk.
When a bladder infection moves upward
The urinary system includes the kidneys, ureters, bladder and urethra. A lower UTI generally affects the bladder or urethra. A kidney infection, known as pyelonephritis, is more serious.
You may notice a change in symptoms when the infection reaches the kidneys. Fever, chills, pain in the back or side below the ribs, nausea, vomiting and feeling markedly unwell can occur. Some people may still have burning or frequent urination, while others mainly develop fever and weakness.
If bacteria enter the bloodstream, the body's response can become widespread. Blood pressure may fall, Heartrate increase, and organs such as the kidneys, lungs or brain may begin to function poorly. This is where a urinary infection can become a medical emergency.
Who needs to be more careful?
The risk is higher in certain situations. Older adults, people with diabetes, individuals with weakened immunity, chronic kidney disease patients and people with non-functioning hydronephrotic kidney will be more vulnerable to complications.
A blocked urinary tract can also make an infection harder to control. Kidney stones, an enlarged prostate or structural problems in the urinary system may interfere with the normal flow of urine. People with urinary catheters can also have a higher risk of complicated infections.
Pregnancy deserves particular attention because a urinary infection can progress to a kidney infection more readily and lead to abortion.
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Do not wait for severe symptoms
One of the common mistakes is assuming that a UTI can always be managed at home. If you have mild urinary symptoms without fever or significant illness, you can contact a doctor and discuss whether testing or treatment is needed.
The situation changes when symptoms begin spreading beyond the bladder.
Seek medical attention promptly if you develop fever or chills along with urinary symptoms, pain in your back or side, repeated vomiting, worsening weakness, confusion, dizziness or difficulty staying awake. Very little urine, rapid breathing, breathlessness or a feeling that you are becoming seriously unwell also requires urgent assessment.
Confusion can be particularly important in older adults. They may not always report burning urine or abdominal discomfort. A sudden change in behaviour, alertness or functioning can sometimes be the first visible sign of a serious infection.
What happens if sepsis is suspected?
Doctors may check your blood pressure, heart rate, breathing rate, temperature and oxygen level. Blood and urine tests can help identify infection and assess whether organs are being affected. Imaging in the form of ultrasound and CT Scan may be required when a kidney stone, obstruction or another structural problem is suspected.
Treatment depends on the severity and cause. Antibiotics are commonly used when a bacterial infection is suspected. People with severe infection may need intravenous antibiotics and fluids in hospital. If urine flow is blocked, treating the obstruction can be just as important as treating the infection.
Also Read: Urinary Tract Infections: Doctor Shares Prevention Tips For Men And Women
Do not use leftover antibiotics
Taking an antibiotic from a previous illness may seem convenient, but it can be the wrong drug, dose or duration for the current infection. Bacteria might be resistant to already used antibiotic. Some urinary symptoms can also have causes other than bacterial infection.
A urine test may be recommended, particularly when symptoms are recurrent, severe, occurring during pregnancy, or accompanied by fever or kidney pain. A urine culture can help identify the bacteria and determine which antibiotics are likely to work.
A simple UTI usually does not become sepsis, but it can happen, particularly when an infection reaches the kidneys or when other risk factors are present.
Pay attention to how your symptoms are changing. Burning urine alone is different from burning urine accompanied by fever, chills, back pain, vomiting or sudden weakness. If you develop confusion, breathing difficulty, very low urine output, severe dizziness or rapidly worsening illness, seek emergency medical care rather than waiting for the symptoms to settle.
Early assessment matters because a urinary infection is generally much easier to treat before it progresses into a serious systemic infection.
(By Dr. Hari Prasad, Consultant - Urology, Manipal Hospital Vijayawada)
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