title: A case of hyperammonemia with obstructive urinary tract infection by urease-producing bacteria.
abstract: A 79-year-old woman was admitted emergently for disturbance of consciousness. Her consciousness level was Japan coma scale 20, and she presented with hypermyotonia. Brain magnetic resonance imaging and cerebrospinal fluid examination showed normal findings. Her blood tests showed an increased ammonia level of 291 μg/dl with normal liver function. We catheterized the bladder for urinary retention. Eight hours after admission, the blood level of ammonia decreased to 57 μg/dl and the patient's consciousness level improved. Corynebacterium pseudodiphtheriticum, which is a bacteria producing urease, was detected from a urine culture. It is important to recognize that obstructive urinary tract infection caused by urease-producing bacteria can cause hyperammonemia.
authors.affiliation: Department of Vascular Neurology, National Hospital Organization Osaka Minami Medical Center.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Goda
authors.forename: Kotaro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Junya
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nagai
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D003244:Consciousness Disorders / Q000209:etiology; D003352:Corynebacterium / Q000201:enzymology* / Q000302:isolation & purification*; D003354:Corynebacterium Infections / Q000150:complications* / Q000382:microbiology*; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology*; D014510:Urease / Q000096:biosynthesis*; D014552:Urinary Tract Infections / Q000150:complications* / Q000382:microbiology* / Q000652:urine; D014556:Urine / Q000382:microbiology
chemical_list: D014510:Urease