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Case Report Volume 15 Issue 6
Neurological functional decline as an atypical presentation of multidrug-resistant Morganella morganii cystitis in a Nonagenarian
Rafael Nascimento, João Loja, Carolina Carvalhinha, Diogo André, João Miguel Freitas, Miguel Homem Costa
Received: November 25, 2025 | Published: December 9, 2025
Citation: Nascimento R, Loja J, Carvalhinha C, et al. Neurological functional decline as an atypical presentation of multidrug-resistant Morganella morganii cystitis in a Nonagenarian. J Neurol Stroke. 2025;15(6):169-170. DOI: 10.15406/jnsk.2025.15.00642
Abstract
Background: Urinary tract infections in the elderly frequently present with nonspecific symptoms such as delirium and may involve multidrug-resistant organisms. Case presentation: We report a case of a 91-year-old male with chronic kidney disease and heart failure presenting with generalized weakness and delirium. Laboratory studies revealed leukocytosis, elevated inflammatory markers, and elevated serum creatinine. CT-scan showed no acute abnormalities and urinalysis showed positive nitrites and significant pyuria. Urine culture isolated Morganella morganii, susceptible only to trimethoprim–sulfamethoxazole. Targeted therapy led to complete clinical improvement. Conclusions: This case highlights the need for comprehensive geriatric assessment, as urinary tract infections in older adults may present atypically. A thorough clinical assessment enables clinicians to distinguish whether delirium is attributable to infection or stroke, thereby preventing unnecessary treatments and allowing for more appropriate patient management.
Keywords: Morganella morganii, uti, delirium, elderly, stroke
©2025 Nascimento, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.