When Should You Go to the Hospital for a Urinary Tract Infection (UTI)?

Seeing blood in your urine unexpectedly is a reason to head to the hospital or emergency department right away. Flu-like signs can also indicate a serious infection, so prompt medical evaluation is important. Early diagnosis and treatment lower the chance of lasting complications.

Most urinary tract infections involve the lower urinary tract — the urethra and bladder — and produce symptoms focused on urination.

But if these lower infections are ignored, they can travel upward in the urinary system. Upper UTIs produce systemic, flu-like symptoms such as fatigue, fever, chills, vomiting, nausea, and pain in the back or side.

“An upper UTI can also cause blood to appear in your urine,” says Monte Swarup, MD, OB-GYN, founder of the health information site HPV HUB.

These warning signs should prompt a visit to the emergency department because they may indicate the infection has reached the kidneys, notes Jill Krapf, MD, OB-GYN, of The Center for Vulvovaginal Disorders in Tampa, Florida.

She adds that medical care is particularly crucial if you’re at higher risk for a complicated UTI. That group includes people who:

• Are pregnant
• Have an immune-compromising condition such as diabetes, cancer, or HIV
• Have an issue that disrupts urine flow between kidneys and bladder, like an enlarged prostate or kidney stones
• Have recently used or currently use a catheter
• Have recently used or are currently on antibiotics

What to expect in the emergency room

According to Krapf, you may undergo a combination of the following evaluations:

• Review of your medical history
• Physical examination
• Urinalysis
• Urine culture
• Blood testing
• Cystoscopy to inspect the bladder for structural problems
• Imaging studies like a CT scan to evaluate kidney involvement

“If you’re found to have a UTI in the ER, the clinician will choose treatment based on how severe the infection is,” she says.

Simple cases are often treated with oral antibiotics. “More serious infections may require hospital admission and intravenous (IV) antibiotics,” Krapf explains.

Consequences of an untreated UTI

To be clear: if you notice UTI symptoms, seek medical evaluation. If a clinician diagnoses a UTI, it’s important to follow the recommended treatment plan.

“If left undetected and untreated, a UTI can progress to more serious health problems, such as kidney injury, renal scarring, and sepsis,” says Swarup. Sepsis can be life-threatening if not addressed.

In certain instances, damage to the bladder or prostate may also develop.

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The bottom line

Certain UTI symptoms — including upper back pain, vomiting, blood in the urine, fever, and chills — require immediate medical attention.

If left untreated, UTIs can worsen and cause serious, sometimes permanent, complications.