Question

My mom is 57, and she has a urinary tract infection; this was discovered about 2 weeks after she had been running a low-grade fever daily, having low blood pressure(usually it's high), lack of skin color, lack of appetite, and being very, very tired. She has had antibiotics yet she has barely improved. Might this infection have spread somewhere else in her body, which could lead to septic shock?

Answer

Urinary tract infections are very common in women. If a woman has many recurrent UTI's during her lifetime some antibiotics can become ineffective against organisms that have become resistant.

When your mother was first seen for her UTI a urine culture should have been done. This simple test incubates the urine for bacterial growth. This bacterial growth is then subjected to the antibiotic she is prescribed to see if it will kill the organisms.

Many times a resistant organism will be found, which the antibiotic will not kill. Other antibiotics are then tested to see which ones are effective. The prescribed antibiotic is then changed to the most effective one.

If this test wasn't done on her initial visit it still can be done, but it may not be as accurate. It's always possible her infection may be a combination of two or more organisms, each sensitive to a different antibiotic.

Another possibility is that the antibiotic was suitable for her but the infection has migrated up to her kidneys (i.e. pyelonephritis). This can cause non-resolving symptoms.

Septic shock should always be in the back of the physician's mind when treating anyone with an infection, especially one that fails to resolve. There are special blood tests that can look for septic shock, if it's suspected.