Journal of Acute Care

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VOLUME 3 , ISSUE 1 ( January-April, 2024 ) > List of Articles

CASE REPORT

Nonhepatic Hyperammonemia Secondary to Escherichia coli Urinary Tract Infection

Pradeep M Venkategowda, Pooja C Patil

Keywords : Ammonia, Case report, Escherichia coli, Nonhepatic, Urease

Citation Information : Venkategowda PM, Patil PC. Nonhepatic Hyperammonemia Secondary to Escherichia coli Urinary Tract Infection. 2024; 3 (1):35-37.

DOI: 10.5005/jp-journals-10089-0102

License: CC BY-NC 4.0

Published Online: 30-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Critically ill patients with hyperammonemia (HA) may suffer high morbidity and mortality. A 78-year-old male presented to a tertiary care hospital with a history of increased drowsiness for 3 days associated with intermittent fever and burning micturition. He was a known case of type 2 diabetes mellitus, systemic hypertension, and ischemic heart disease. Ultrasound abdomen revealed a thickening of the urinary bladder suggestive of cystitis. The renal and kidney function tests were normal. The serum ammonia level was 88 mg/dL (normal levels <40 mg/dL). Urine culture grew Escherichia coli (E. coli). Diagnosis as urinary tract infection (UTI) with E. coli and HA was made and the patient managed with parenteral meropenem, insulin, intravenous fluids, antihypertensives, low protein, and high-calorie diet. The patient's clinical condition improved gradually and later discharged home in hemodynamically stable condition. This case report highlights a rare case of HA secondary to E. coli-related UTI.


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