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Warning Signs of a UTI

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Top Takeaways


  1. Seniors often get complicated urinary tract infections (UTI). These infections result in more medical complications and are harder to cure than uncomplicated UTIs.
  2. UTIs can be very serious in seniors.
  3. You should know the warning signs of UTIs in seniors. Knowing and watching out for these signs might help you obtain earlier treatment and evaluation, and possibly prevent serious complications.
  4. A list of the warning signs of UTI is presented in this article.
  5. In seniors, UTI symptoms may not be typical of those seen in younger, healthier patients.
  6. Notify your senior's healthcare provider promptly if you suspect a UTI.


What are the two categories for UTIs?


Urinary tract infection (UTI) consists of two main categories: 


1. Uncomplicated Infections

These UTIs do not pose a significant risk of complications. This kind of UTI does not typically occur in elderly patients.


2. Complicated infections 

This is the type of UTI that often occurs in elderly patients. Complicated UTIs are expected to result in complications and/or be difficult to cure. Typical examples include UTI’s that are associated with:

    • Known or suspected physical abnormality of the urinary tract or kidneys. This can include blockages or recent medical/surgical procedures recently performed on the urinary tract.
    • Known or suspected abnormalities in the way the urinary tract or kidneys function. This can include nerve damage to the bladder or certain types of urinary incontinence.
    • Recent placement of a plastic tube (catheter) into the bladder, or someone who frequently or regularly has a urinary catheter in place
    • Diabetes
    • Immunocompromised patients (that is, those with weakened immune systems)
    • Other severe underlying medical conditions


A UTI can be a serious matter in seniors. Know the warning signs of UTIs. Taking action when these signs appear might help you obtain medical evaluation and treatment before a UTI becomes a serious or even life-threatening matter. This article will describe the typical warning signs of UTIs in seniors.


Warning Signs of UTI in Seniors


1. Frequency: This refers to urinating unusually frequently


2. Dysuria: This refers to pain or other discomfort when urinating


3. Urgency: This refers to the unusual sensation of sudden and immediate need to urinate


4. Complaints of suprapubic pain, or tenderness in the suprapubic area: The suprapubic area is located right above the bone that’s just above the genitals. The suprapubic area is also at the very bottom of the abdominal region.


5. Flank pain: This is pain in the mid-back, near the bottom of the rib cage and towards the outer back. 


6. Fever: Normal temperature is approximately 97º to 99º Fahrenheit (F); normal will vary from person to person within this range. A fever is often considered at or above 100.4º F. Be aware that the following people may not display a fever, even if they have a UTI or other severe infection:

    • Seniors
    • People with certain serious diseases
    • People on certain medications that block or interfere with mounting a fever


7. Abnormally low temperature: This would typically be below 97º F. If the temperature is below 95º F, this should be considered a medical emergency.


8. Abnormally cool, bluish, or purplish blotched skin of new onset: This can indicate a medical emergency, and you should seek immediate medical attention.


9. Chills or uncontrolled shaking with chills


10. Nausea


11. Vomiting


12. Blood in the urine


13. Cloudy or whitish appearing urine


14. Urine with an unusual or foul smell


15. Confusion or disordered thinking that’s new or is worse than your loved one’s baseline


16. New-onset urinary incontinence in someone without incontinence, or worsening incontinence in someone who has chronic incontinence


17. Increased fatigue or decrease in usual activity tolerance


18. Pain anywhere between the flank (midlevel and outer area of the back) and the genitals on one side: This could indicate a kidney stone that’s moving or stuck. In the elderly, kidney stones can be associated with a complicated UTI.


19. Prior history of UTI


20. Previous or currently suspected complicated UTI

Examples include UTI with:

    • Kidney stones
    • Infection of the kidney tissue
    • Blockages in the urinary tract
    • Tumors of the urinary tract
    • Incontinence
    • Infection that spreads into the blood (known as sepsis) or to other organs
    • Recent surgical procedure performed anywhere in the urinary tract. A common one is for procedures on men’s prostate glands.
    • Significant neurologic disease that affects the urinary system
    • Patients who are immunocompromised. Treatment with certain drugs for autoimmune diseases (like lupus), respiratory diseases (like emphysema), or drugs for organ transplants commonly cause immunocompromised.
    • Coexisting diabetes
    • Prior hospitalizations for UTI


21. Chronic use of antibiotics: This can result in UTI with bacteria that are very resistant to treatment.

Important Special Issues for Warning Signs of UTI in Seniors


1. UTIs in seniors are typically the complicated type: These complicated UTIs can signal severe medical conditions or result in serious medical complications. 


2. Seniors with UTIs may display atypical symptoms: Atypical means unusual, uncommon, or not typical symptoms seen in younger, healthier people. Symptoms of a UTI that you notice in a senior might not match the usual or expected symptoms for a UTI. Therefore, it’s essential to watch for unusual or more subtle signs of a UTI when dealing with seniors.


NOTE: It’s wise to seek prompt medical advice and attention if you believe your senior has a UTI. In particular, if there are symptoms of a serious UTI, be sure to contact a qualified health care professional emergently.

Stephen Engle, MD

Stephen Engle is a United States-trained physician (M.D.) and Diplomate of the American Board of Internal Medicine who is board-certified in internal medicine. He has experience as a medical director in administrative medicine with the largest private payer in the US, as well as experience in internal medicine at all levels (clinic, urgent care, emergency room, inpatient general and intensive care, clinical consultative medicine, and peer review.)

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