Delirium in Urinary Tract Infections

Patients with urinary tract infections (UTI) may experience symptoms beyond those typically associated with a UTI. In older adults, UTIs may progress beyond the urinary tract and kidneys into the rest of the body, causing delirium and other symptoms.

Urinary Tract Infections

• Urinary tract infections occur when bacteria enter the urinary tract. This may be because of low urine flow, poor hygiene, or the use of urinary catheters in incontinent patients. Some UTIs occur without a known exposure.

Kidney Infections

• If a UTI goes untreated for some time, the bacteria may migrate up the urinary tract and infect the kidneys. Further lack of treatment may allow the bacteria to enter the blood stream and cause bacteremia (a blood infection).

Bacteremia

• Bacteremia is very serious and could be life-threatening since the blood circulation allows the bacteria to migrate to all areas of the body, causing a worse infection. While a simple UTI may only have slight symptoms, bacteremia causes fever, malaise, and, in some cases, delirium and disorientation.

Older Adults and UTIs

• Older adults are at risk for untreated UTIs because they may not recognize the symptoms or confuse them with incontinence or other conditions. They are also at risk for kidney and blood infections from UTIs since their immune systems are weakened due to their age.

Differential Diagnosis

• Most health care providers will consider an untreated UTI or bacteremia in the differential diagnosis of a patient with delirium or other signs of a systemic (body-wide) infection. Diagnostic tests that include a urine analysis, blood cultures and complete blood count may help in the diagnosis.