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UTI and altered sensorium - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3632 Questions
User :   For the last 2 days, my dad is on Depsonil, Doluxyl, Nurokind, Zocef CV 500 and Becpec 5 mg for reduction on urinary incontinence (which occurred due to Prostrate Gland surgery)
He is 74 years of age
Since this morning, he has been very drowsy and his speech is a bit slurred. When i ask him, he says his dentures are loose and that is why his speech is like that.
One of our doctors visited him and he mentioned that the speech is slurred but that my dad claims it is because of dentures.
1. Is it because of the medicines he is on?
2. Anything to worry or any immediate check-ups to be done?
Doctor :   hi
Doctor :   Let me read your query
User :   sure
Doctor :   may I know, why the surgery was done?
User :   Not sure, the doctor mentioned that he needed a hernia + Prostrate gland and we went for both together
Doctor :   Is he able to carry our his daily activities, eat food, wear his clothes,
User :   yes
Doctor :   Is he conversing properly with the rest of the family?
User :   while driking soup about an hour back , he spilled it down
User :   he is conversing sensibly but everyone can feel that the speech is not very clear
Doctor :   Does this happen a lot, before?
Doctor :   OK
User :   no, this is the first time
Doctor :   Is he eating his food, properly?
User :   our doctor was suspecting that it could be due to nurokind
User :   yes, he is eating properly
Doctor :   How is his urine output?
User :   better after the medicines, he is out od diapers in 1 day
User :   i mean - out of diapers
User :   urine output is ok
Doctor :   y is he on zocef CV 500
Doctor :   Does he have any infection?
Doctor :   as it is an antibiotic
User :   no, i guess he is on zocef because of the incontinence
User :   oh ok, not sure
User :   all these medicines were prescribed just 2 days back - day before yesterday night, to be precise
Doctor :   did he have prior urinary infection?
Doctor :   ok, i guess, he had a UTI, so he was given prophylactic meds
User :   yes, last month, he had boils and he used Augmentin - 2 courses
Doctor :   i feel his electrolytes , may be a bit changed, due to the stress of infection
Doctor :   Does he have diabetes, etc?
User :   no, he has BP, under medication, now at 140/80
Doctor :   ok
Doctor :   So did your doctor examine him today?
User :   yes, actually i am in a different city and when i called our family doctor, he examined him today and felt that it could be due to Nurokind
Doctor :   Is he a physician, or a urologist
User :   physician
Doctor :   I am of the opinion, that he needs a few blood tests, to check his electrolytes.
Doctor :   Low sodium, (hyponatremia) is common in BPH patients, post surgery
Doctor :   and this can present as alterred sensorium, altered speech
Doctor :   decreased communication
Doctor :   and this condition increases with, presence of any kind of infection
User :   just so that i am clear, his surgery happened 2 months back... and the uro surgeon referred us to the urologist 2 days back who gave the above medicnes
User :   can low sodium happen 2 months after the surgery?
Doctor :   YES, any kind of infection, & reduced food intake can cause this problem
User :   ok
User :   so you suggest blood tests?
Doctor :   yes , they would rule out other conditions
Doctor :   and prevent complications
User :   ok, should we go for a complete blood test or any specific ones?
Doctor :   Get a CBC, serum elecrtolytes, done
User :   ok
User :   no medical emergency needed, correct?
Doctor :   this will help to rule out hyponatremia
User :   ok
Doctor :   if he is talking, and responding, in a normal way,
User :   yes, he is
Doctor :   it is not a emergency, but better be safe
User :   responding pretty normally
User :   sure, thank you
Doctor :   you are welcome
Doctor :   also get a urine culture and urine analysis to rule out Urinary infections as well
User :   sure
User :   Thank you
Doctor :   these tests, will be good for him

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