UTI/Infection

[DieselBolus17]

Hi all, I've been searching all over the net for a simple answer and cannot seem to find one.... How exactly does a UTI or an infection cause altered mental status/delirium/confusion? Had a 83 y/o female the other day, per daughter pt. went to bed at 10 pm and woke up at 7 am to self cath (hx of kidney failure) and pt. appeared to be confused and unable to cath her self, which she has been doing for over 20 years. I immediately thought thought of a UTI due to her self cathing, ect. However as I did my assessment pt. followed commands and I noticed she had some difficulty speaking, per daughter she's normally real sharp and has no speech/cognitive problems. I asked pt. if she understood what I was saying and if she had difficulty saying what she wanted to say and said yes. I went out on a limb and called a stroke alert because of expressive aphasia and she ended up having a stroke... Anyways, that's besides the point, I would like to know how exactly a UTI or infection causes confusion?

Thank you

 

[Angel]

i hope this is the answer
but the lack of urination causes a build up in uremia, which can lead to uremic encephalopathy

http://emedicine.medscape.com/article/239191-overview#showall

 

[teedubbyaw]

i hope this is the answer
but the lack of urination causes a build up in uremia, which can lead to uremic encephalopathy

http://emedicine.medscape.com/article/239191-overview#showall

That's different than a UTI. UTI's are often accompanied by frequent urination/urge to urinate. It's usually at the point of sepsis when a person becomes altered, with hypotension being the main factor. Inflammatory factors, increased capillary permeability, end toxins from the infection process are all contributing factors.

On cell phone so I'll stop there.