When Fever is Just the Tip of the Iceberg: A Case of Urinary Sepsis with A typical Presentation

Abstract

Background: Urinary sepsis in older adults often presents atypically, delaying recognition. Early markers and clinical judgment are crucial for rapid diagnosis and treatment.

Case History: An 84-year-old woman with dementia and incontinence was admitted for fever and confusion. Vitals: BP 95/60 mmHg, HR 110 bpm, SpO₂ 94%. Labs showed WBC 17,000/mm³, CRP 230 mg/L, lactate 3.8 mmol/L. Urinalysis was suggestive of infection; culture confirmed ESBL Klebsiella pneumoniae. Empirical meropenem and fluids were administered. Patient improved within 48 hours.