Abstract

Background: Urinary tract infections in the elderly frequently present with nonspecific symptoms such as delirium and may involve multidrug-resistant organisms. Case presentation: We report a case of a 91-year-old male with chronic kidney disease and heart failure presenting with generalized weakness and delirium. Laboratory studies revealed leukocytosis, elevated inflammatory markers, and elevated serum creatinine. CT-scan showed no acute abnormalities and urinalysis showed positive nitrites and significant pyuria. Urine culture isolated Morganella morganii, susceptible only to trimethoprim–sulfamethoxazole. Targeted therapy led to complete clinical improvement. Conclusions: This case highlights the need for comprehensive geriatric assessment, as urinary tract infections in older adults may present atypically. A thorough clinical assessment enables clinicians to distinguish whether delirium is attributable to infection or stroke, thereby preventing unnecessary treatments and allowing for more appropriate patient management.

Keywords

Morganella morganii, uti, delirium, elderly, stroke