A urine infection is germs climbing up the wrong way.
Urine is normally free of germs. A urine infection happens when germs, most often from the bowel, get in through the tube that carries urine out and climb up into the bladder. Most stay there. A few climb further, up to a kidney, and that is a more serious illness.
In plain words.
Urine infections are far more common in women, because the tube is short. Pregnancy, diabetes, kidney stones, not drinking enough, and the years after the menopause all make them more likely. In men they are less common, and each one is worth checking for a cause such as an enlarged prostate.
A bladder infection gives burning, a constant urge and cloudy urine, but usually no high fever. A kidney infection brings fever with shivering, pain in the side or back, and feeling sick. It needs treatment the same day.
Antibiotics treat them, but in India many urine germs are resistant to common antibiotics. So a urine culture, sent before the first dose, tells which antibiotic will work. Bacteria found on a test in someone with no symptoms usually need no antibiotic, except in pregnancy.
Where the germs go
Germs enter through the short outlet tube and multiply in the bladder. Its lining turns red and sore: burning, urgency and cloudy urine.
Sometimes they climb on up the ureter to a kidney. Now there is fever, shivering and pain in the side. This needs a doctor the same day.
Go to hospital now if
- Fever with shivering and pain in the side or back, and you are vomiting or cannot keep fluids down: go to hospital now.
- Confusion, drowsiness, fast breathing, or feeling faint or cold and clammy: call 112. The infection may have spread into the blood.
- You cannot pass urine at all and the tummy is painful and full: go to hospital now.
- You are pregnant and have fever or back pain: go to hospital now.
Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).
See a doctor within a day if
- You have fever, or pain in the side or back, even if you can drink
- You are a man with urine symptoms
- You are pregnant, or have diabetes or kidney disease
- Symptoms have not improved after two days of treatment
- Blood in the urine, or infections that keep coming back
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| Urine routine and microscopy | Pus cells and bacteria point to an infection. A quick first look. |
| Urine culture and sensitivity | Grows the germ and names the antibiotics that work on it. Give the sample before starting any antibiotic. |
| Blood sugar | Diabetes makes infections more likely and more serious. |
| Kidney function (creatinine) | In kidney infections, and in anyone unwell. |
| Ultrasound of the kidneys and bladder | For kidney infections, infections in men, or repeated infections: looks for stones, blockage or an enlarged prostate. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Do not take leftover antibiotics, or one bought without a prescription. A wrong or short course can let a bladder infection climb to the kidneys, and breeds germs that no tablet can treat.
A video call can
- Tell a simple bladder infection from one that needs closer care
- Arrange the right urine tests before treatment starts
- Choose an antibiotic, and change it if the culture shows it will not work
- Look for the cause when infections keep coming back
Needs a visit in person
- Urine and blood tests, at a laboratory or by home collection
- An ultrasound scan
- Injected antibiotics or a drip for a kidney infection with vomiting
- Any sign in the red box: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759