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Urology  (Expert Forum)
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Would a UTI have this effect?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Would a UTI have this effect?

by millege1, Jun 01, 2006 12:00AM
My mother has been hospitalized for 3 weeks with a UTI. She is 79, and has been in fairly good health except for renal insufficiency and diabetes. UTI started out as a low grade fever. She was first given Levaquin-was ineffective. Dr. prescribed Bactrim- She then began vomiting and was very nauseous. Several anti-nausea drugs were administered. 6 days after she was admitted, she became delirious. She knew who we were, and knew all the answers to questions she was asked, but she said inappropraite things and could not distinguish between reality and what her mind was seeing. Dr. switched to Macrodantin as he felt it was less harsh on her system. She seemed to improve, was able to get up and walk withhelp, feed herself, use the telephone. By the end of the next week, however, she was back to being in a "brain fog." Sunday past the Dr. started her on Rocephin. Today is the 5th day of this treatment. She is always cold, very lethargic- she sleeps most of the day- has no strength, can hardly feed herself. When she closes her eyes, you can see her eyeballs roll back and forth under her eyelids. It's as if she wants to wake up, but can't do it. She was also havingtremors in her hands, and her body was shaking as if with a seizure, so a neurologist was consulted and placed her on Dilantin because her prolactin level was elevated.



My question is, would a severe UTI cause such symptoms and problems? Our doctors are trying their best, but haven't said much. She was doing so good, and now it seems like she's taken three steps backward for every one forward.

by Kevin Pho, MD, Jun 02, 2006 12:00AM
An inappropriately treated UTI can lead to mental status changes in the elderly.  It seems like a variety of antibiotics have been tried.  You can ask whether a culture and sensitivity test of the urine was positive.  That can help narrow the choice of appropriate antibiotic.  If there continues to be signs of an infection, a referral to an infectious disease specialist can be considered.  



If the change in mental status continues despite appropriately treating the infection, a re-examination by a neurologist can be considered.  Going through her list of medications should also be done as well.



These options can be discussed with her personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_
Member Comments (3)

by millege1, Jun 02, 2006 12:00AM
To: Urinary Tract Infections
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by Thuney, Jun 07, 2006 12:00AM
To: Urinary Tract Infections
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by jakesma, Jun 14, 2006 12:00AM
To: Urinary Tract Infections
0
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