• Major symptoms and time course – differentiate between lower urinary tract symptoms, upper tract symptoms and systemic features
• Previous history of urinary tract infections
• Antibiotic history
• Presence/absence of urinary catheter, recent catheterization, blocked catheter, catheter change
• History of recent urinary tract intervention or urological intervention
• Previous history of renal tract pathology such as chronic kidney disease, renal stones, single kidney, structural abnormality
• Pregnancy?
• Diabetes?
• Sexual history
• If primarily urethritis or penile discharge, consider sexually transmitted infections (Neiserria gonorrhoea, Chlamydia trachomatis, Herpes simplex, Trichomonas vaginalis)
• Symptoms of sexually transmitted infections and epididymo-orchitis?
• Review any recent GP or hospital microbiology results
• Consider points relevant to differential diagnosis – gastrointestinal symptoms

Examination

• Vital signs and key observations if critically ill and resuscitate as appropriate
• Assessment of presence/absence of loin tenderness
• Presence or absence of catheter and quality of catheter urine
• Consider alternative source of sepsis