Question 89 · LEK · Urinary tract infections
An 80-year-old resident of the nursing home was brought to the Emergency Room because of the deterioration of contact and decreased strength of her right lower limb lasting for 5 hours. There are no reports on the fever nor abdominal pain. The urinalysis revealed proteinuria 0.1 mg/dL, leukocytes 15-20 per hpf with numerous bacteria present. She has CRP 10 ng/mL (n < 5 ng/ml), normal complete blood count and eGFR 39 mL/min. Indicate the most probable cause of the symptoms:
- A. acute pyelonephritis.
- B. acute glomerulonephritis.
- C. renal colic caused by nephrolithiasis.
- D. bladder infection (cystitis).
- E. described changes in the urea are typical of elder patients and should not be an indication for antibacterial treatment if they are not accompanied by clinical symptoms.
Hint
Separate the urine findings from the acute focal neurological deficit and ask whether bacteriuria alone can explain this picture.
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