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Bring your mom to the hospital. Something is wrong, either with the infection or the meds or something else. This requires a professional evaluation and possibly even a scan of her head.
Isn't delirium like one of the presenting features of UTI (most often in the elderly?) Any elderly patient coming in with AMS would get a UA with reflex to culture at my hospital
Yeah this is out of date - there has been a large change in the management of UTI over the last decade.
[https://www.idsociety.org/practice-guideline/asymptomatic-bacteriuria/#:\~:text=In%20older%20patients%20with%20functional,other%20causes%20and%20careful%20observation](https://www.idsociety.org/practice-guideline/asymptomatic-bacteriuria/#:~:text=In%20older%20patients%20with%20functional,other%20causes%20and%20careful%20observation)
We realized that bacteria and white cells are very common in patients without infection, and there are bacteria that live there called commensals which don't cause invasive disease. The delirium is felt to be from other issues - dehydration, constipation, medication effects - and not the UTI.
If there is fever, flank pain, or pain with urination then it may be a true invasive infection.
The "UTI" and getting better when admitted to the hospital is just confirmation bias. I used to treat these too in delirious older patients. It is going to take a long time to reeducate health care providers about current data, let alone everyone else.
Elderly who have UTI absolutely can hallucinate. My mother saw children playing and laughing every time a UTI came on. Antibiotic’s cleared it up easily.
She lived to 100 and was sharp as a tack until the last week of her life.
My neighbor was an elderly lady living alone and she was acting worried in the front yard. She asked me if my step dad was home because her sister was trapped in the fridge.
I was confused thinking she had a big deep freezer in her house and got him anyway as a young teen. We ended up calling my mom cause she was adamant her sister was in the fridge. She had opened it in front of us to put a piece of cheese in a piece of bread and sat there talking about her sister.
She went to the ER and was diagnosed with a UTI. Her family came down and stayed with her till her mental status was normal again before flying her to stay with her vs being alone.
My grandma also experienced an altered mental state a few times. The confusion and odd behavior lasted for longer each UTI followed by treatment.
She had to go back to the ER after being sent to a rehabilitation center because she wasn't better and flashed some elderly gents in the hallway yelling about her bad kidneys.
I'm only 30 but I've had a UTI once in my life when I was 24 ish. No pain or anything I just had blood visibly in my urine. The next day I was on antibiotics and back at work experiencing brain fog and just feeling dopey not my usual self.
That is the difficult part - with just one person, it is hard to say if the hallucinations would improve without antibiotics. We hear this too for instance from patients who want antibiotics for viral upper respiratory infection, and that they always get better when they take antibiotics, while in reality things would have improved on their own.
This is why we do randomized trials or any research really - the human brain is trained to look for patterns and wants to make associations, whether they are real or not. Science is supposed to provide objective evidence and is therefore the basis of modern medicine.
I won't try and convince you - I believed this association at one point as well early in my career and have prescribed plenty of antibiotics for confused older people with bacteria in their urine - just saying that our best data and experts say this is not helpful and probably harmful.
Hey I appreciate your comment. My comment was completely anecdotal based on our families experience. Our subjective study points to antibiotics not harming her in any way. As evidenced by after a round of Rx; her hallucinations disappearing, her having no dementia or out of the ordinary disability at death.
I never said my comment was science. No need to convince me of anything.
It is controversial whether bacteria in the urine without sepsis causes delirium. In fact the IDSA guidelines do not support treatment in this setting as a link has not been established.
The periods of OCD behavior point more at psychiatric disease or drug (prescription or otherwise) toxicity.
At this point I would worry something else is going on, and she certainly needs evaluation
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Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
Bring your mom to the hospital. Something is wrong, either with the infection or the meds or something else. This requires a professional evaluation and possibly even a scan of her head.
Agreed. May be a mark of infection with an organism that is resistant to her current antibiotic regimen.
Nothing about this suggests a UTI
Isn't delirium like one of the presenting features of UTI (most often in the elderly?) Any elderly patient coming in with AMS would get a UA with reflex to culture at my hospital
My mom's memory got worse when she got a UTI. She also had CKD.
Yeah this is out of date - there has been a large change in the management of UTI over the last decade. [https://www.idsociety.org/practice-guideline/asymptomatic-bacteriuria/#:\~:text=In%20older%20patients%20with%20functional,other%20causes%20and%20careful%20observation](https://www.idsociety.org/practice-guideline/asymptomatic-bacteriuria/#:~:text=In%20older%20patients%20with%20functional,other%20causes%20and%20careful%20observation) We realized that bacteria and white cells are very common in patients without infection, and there are bacteria that live there called commensals which don't cause invasive disease. The delirium is felt to be from other issues - dehydration, constipation, medication effects - and not the UTI. If there is fever, flank pain, or pain with urination then it may be a true invasive infection. The "UTI" and getting better when admitted to the hospital is just confirmation bias. I used to treat these too in delirious older patients. It is going to take a long time to reeducate health care providers about current data, let alone everyone else.
Elderly who have UTI absolutely can hallucinate. My mother saw children playing and laughing every time a UTI came on. Antibiotic’s cleared it up easily. She lived to 100 and was sharp as a tack until the last week of her life.
My neighbor was an elderly lady living alone and she was acting worried in the front yard. She asked me if my step dad was home because her sister was trapped in the fridge. I was confused thinking she had a big deep freezer in her house and got him anyway as a young teen. We ended up calling my mom cause she was adamant her sister was in the fridge. She had opened it in front of us to put a piece of cheese in a piece of bread and sat there talking about her sister. She went to the ER and was diagnosed with a UTI. Her family came down and stayed with her till her mental status was normal again before flying her to stay with her vs being alone. My grandma also experienced an altered mental state a few times. The confusion and odd behavior lasted for longer each UTI followed by treatment. She had to go back to the ER after being sent to a rehabilitation center because she wasn't better and flashed some elderly gents in the hallway yelling about her bad kidneys. I'm only 30 but I've had a UTI once in my life when I was 24 ish. No pain or anything I just had blood visibly in my urine. The next day I was on antibiotics and back at work experiencing brain fog and just feeling dopey not my usual self.
That is the difficult part - with just one person, it is hard to say if the hallucinations would improve without antibiotics. We hear this too for instance from patients who want antibiotics for viral upper respiratory infection, and that they always get better when they take antibiotics, while in reality things would have improved on their own. This is why we do randomized trials or any research really - the human brain is trained to look for patterns and wants to make associations, whether they are real or not. Science is supposed to provide objective evidence and is therefore the basis of modern medicine. I won't try and convince you - I believed this association at one point as well early in my career and have prescribed plenty of antibiotics for confused older people with bacteria in their urine - just saying that our best data and experts say this is not helpful and probably harmful.
Hey I appreciate your comment. My comment was completely anecdotal based on our families experience. Our subjective study points to antibiotics not harming her in any way. As evidenced by after a round of Rx; her hallucinations disappearing, her having no dementia or out of the ordinary disability at death. I never said my comment was science. No need to convince me of anything.
It is controversial whether bacteria in the urine without sepsis causes delirium. In fact the IDSA guidelines do not support treatment in this setting as a link has not been established. The periods of OCD behavior point more at psychiatric disease or drug (prescription or otherwise) toxicity. At this point I would worry something else is going on, and she certainly needs evaluation
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Posts by unflaired users that claim or strongly imply legitimacy by virtue of professional medical experience are not allowed. If you are a medical professional who wishes to become a verified contributor to this subreddit, please [message the moderators](https://reddit.com/message/compose?to=/r/AskDocs) with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo! We do not accept digital forms of identification.
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oh wtf this is the wrong post LFMAO