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• Vol.57 No.3
• CLINICA NEUROL, 57: 130−133, 2017
• Vol.57 No.3 contents

Brief Clinical Note

A case of hyperammonemia with obstructive urinary tract infection by urease-producing bacteria

Toshiaki Goda, M.D.¹⁾, Kotaro Watanabe, M.D.¹⁾, Junya Kobayashi, M.D.¹⁾, Yasuharu Nagai, M.D.²⁾, Nobuyuki Ohara, M.D.¹⁾ and Daisuke Takahashi, M.D.¹⁾

¹⁾Department of Vascular Neurology, National Hospital Organization Osaka Minami Medical Center
²⁾Department of Urology, National Hospital Organization Osaka Minami Medical Center

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.
Full Text of this Article in Japanese PDF (351K)

(CLINICA NEUROL, 57: 130−133, 2017)
key words: hyperammonemia, urease-producing bacteria, urinary tract infection

(Received: 31-Dec-16)