Asymptomatic BacteriuriaClinical Pearls of Wisdom Q&A Case
Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities or those who have bladder catheters inserted for an extended period. Asymptomatic bacteriuria is a condition in which larger than normal numbers of bacteria are present in the urine but symptoms do not result.
Asymptomatic Bacteriuria Case:
A 76-year-old woman with Alzheimer’s disease, hypertension, hyperlipidemia and coronary artery disease resides in a skilled nursing facility (SNF), in a memory-care unit. Two days ago, she was found on the floor, just outside the bathroom door. She was transported to the emergency department for evaluation.
There, she was confused, but afebrile.
- Her blood pressure was 136/74 mm Hg, pulse was 86.
- Her urinalysis showed 2+ leukocytes and urine was sent for culture.
- Her white blood cell count was 9800/mm3 and her creatinine was 0.9 mg/dL.
- A CT scan of the head and neck showed no evidence of trauma but did show cerebral atrophy and cervical spondylosis.
- She did not complain of headache, neck pain, or dysuria and was sent back to SNF.
Now, you receive the results of her urine culture, which show 150,000 Colony Forming Units of E. coli.
You call the nursing home and find out that she remains confused, but that vital signs are normal.
What is the correct next step in response to this positive urine culture result?
See the Answer:
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