Example case 13 of 40
The urine culture is positive
Check what the result actually explains
Mrs Campbell, 86, has delirium. An earlier urine culture grows bacteria.
Click or tap each illustration to enlarge it. The commentary and text transcript follow below.
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Page 1
Panel 1
Mrs Campbell, 86, has delirium. An earlier urine culture grows bacteria.
Daughter: Does that mean this is a urine infection?
Panel 2
Assessment finds no urinary symptoms, fever or circulatory instability.
Doctor Ali: The culture does not establish a urinary infection by itself.
Panel 3
The doctor examines her and looks for other causes.
Nurse Brown: She has been drinking very little and has painful arthritis.
Panel 4
Dehydration and pain are treated. Her medicines are reviewed.
Doctor Ali: We will check how she responds to this care.
Panel 5
Antibiotics are not started for the culture result alone.
Doctor Ali: We are monitoring her closely for signs of infection.
Panel 6
That evening she remains confused, though more comfortable.
Mrs Campbell: Am I staying here tonight?
Panel 7
Staff repeat observations and assess new symptoms.
Nurse Brown: Please tell us about any new pain or feeling unwell.
Panel 8
The plan includes prompt reassessment if her condition worsens.
Doctor Ali: New infection signs would change our assessment and treatment.
Panel 9
Next morning she drinks more. Delirium assessment and care continue.
Daughter: She follows me better, but still loses track.
Commentary
Bacteriuria alone does not establish symptomatic urinary infection. In a clinically stable older person without local urinary or systemic infection features, assess other causes and observe carefully.
An anonymised composite case that does not describe one identifiable person and is not research evidence.