A case of hyperammonemia caused by urinary tract infection due to urease-producing bacteria in dementia with Lewy bodies

An 87-year-old woman diagnosed with dementia Lewy bodies (DLB) 2 years earlier was referred to our institution because of difficulty walking. She urinary tract infection and admitted hospital. During hospitalisation, she became delirious, which prompted the administration haloperidol. Afterwards, an altered level consciousness noted, measuring 300 on Japan coma scale. A blood test revealed hyperammonaemia without liver damage. Urine culture detected presence Corynebacterium urealyticum. Therefore, we this case as one due caused by urease-producing bacteria. Soon after insertion a urethral catheter, ammonia decreased, improved. In case, patient took medication preserve her bladder function, is frequently associated DLB. We suspected that drug retention, resulting in hyperammonaemia. Hyperammonaemia these bacteria should be considered DLB patients impaired consciousness, especially those using regulators function.