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Urgent same-day assessment or emergency care is warranted if: Fever above 38C with rigors or shaking chills Loin pain or flank tenderness suggesting upper urinary tract involvement Severe systemic symptoms confusion, severe malaise, or vomiting Inability to tolerate oral fluids due to persistent vomiting Visible haematuria with clots indicating significant bleeding These features may indicate pyelonephritis or complicated UTI requiring urgent medical evaluation and possible hospital admission for intravenous antibiotics

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doi: 10.1016/S2213-8587(17)30013-X 22 ArodaVRRosenstockJTerauchiYAltuntasYLalicNMMorales VillegasECet al