DEAR DR. GOTT: I think people need to be aware of this. My otherwise healthy mother, age 81, has had two urinary tract infections this year that presented with only delirium and confusion. She had no need to use the bathroom, no pain or burning, only a rather sudden onset of frightening confusion, including hallucinations.
She has been diagnosed with depression and mild cognitive impairment/early dementia. I understand from two nurses that delirium is often the only symptom that presents in elderly folks with UTIs. It is very scary but easily tested for and cured with antibiotics. I worry about others who do not know about this and whose loved ones end up in danger if no one knows about this. I hope you will spread the word. Thank you.
DEAR READER: Urinary tract infections are common, especially in women. The typical signs of pain or burning during urination, frequency, decreased output, pelvic pain, cloudy urine, pink or cola colored urine (due to blood), and more are fairly well-known. Drinking cranberry juice may also decrease symptoms in some sufferers while awaiting a physician’s appointment for testing and treatment.
However, in the elderly and especially those with dementia or cognitive impairment, these symptoms may not be present. Instead, the infection may present with fever, hallucinations, delirium or confusion, much like your mother had. In instances like this, treatment may be delayed, resulting in infection that spreads to the kidneys and can cause serious and/or potentially permanent damage. When this occurs, the otherwise simple treatment of a UTI becomes more complex. A normal UTI treated within an appropriate time frame typically resolves with one to two weeks of antibiotics, whereas a kidney infection can take weeks or months of antibiotics before improvement is seen and the infection eradicated.
I thank you for writing to remind both me and my readers, of these unusual UTI symptoms. My recommendation for those who care for the elderly is to seek immediate medical advice and request a urinalysis and possibly a urine culture should delirium or confusion suddenly present. While an infection may not be the cause, it is readily ruled out and is easily treated, should it be the culprit.
Readers who are interested in learning more can order my Health Report “Bladder and Urinary Tract Infections” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from my website, www.AskDrGottMD.com.
