What is your approach to the management of asymptomatic bacteriuria in an elderly patient without clear urinary symptoms but with cognitive changes and falls?  

Asymptomatic bacteruria does not cause altered mental status. Data suggests that when we attribute acute changes to it, we will be wrong about 85% of the time, thereby missing the true etiology. It is a difficult thing to educate staff of senior living facilities and families who have been told it w...

Could not agree more with Dr. @McCormick. It is very difficult to reeducate medical staff and patients who have been trained to attribute mental status changes alone to urinary findings. We should look for the true culprit, such as underlying cognitive disease (dementia, Parkinson's, stroke), or po...

I 100% agree with others, and just wanted to share a paper I find helpful when I'm trying to change hearts and minds on this topic: Mayne et al., PMID 30717706.

This is probably the best question I've seen that is geared toward Hospital Medicine. Making the diagnosis of UTI is taught to be straightforward, but the actual practice is extremely nuanced. The key to remember, even in geriatric patients, is that symptoms are key! If the only presentation is con...