Acute Psychosis Precipitated by Urinary Tract Infection in a Patient with Gliosis of the Basal Ganglia

Abstract

Background: Urinary tract infections (UTI) have been found to be associated with a variety of neuropsychiatric disorders, and could play a role in the pathophysiology of relapse of affective and nonaffective psychosis. In addition, prior history of infarction in areas of the brain such as the cerebellum, basal ganglia, and mid-brain have been reported in patients with new onset psychotic symptoms. Case presentation: A 29-year-old woman was brought to the hospital with acute mental status changes and signs of sepsis. Infectious work-up was initiated including blood cultures, brain imaging, lumbar tap and urinalysis. Brain MRI revealed abnormalities in the basal ganglia and the urinalysis revealed signs of a urinary tract infection (UTI). Further history revealed episodes of mania and depression compatible with bipolar disorder with psychotic features that had acutely worsened. The patient's condition improved with intravenous antibiotics and the introduction of anti-psychotics. She was discharged in stable condition with outpatient psychiatric follow-up. Conclusion: Infectious diseases (UTIs in particular) are not only more prevalent among patients with acute relapse of psychiatric disorders, but have also been found to have triggered acute psychosis among stable psychiatric patients. Organic brain lesions must be thoroughly investigated among patients presenting with new psychiatric disorders in order to initiate appropriate therapy to control the symptoms.

A Grading System to Assess Female Sexual and Reproductive Psychiatry and Identification of a New Syndrome

“…Past or persistent chronic medical history is equivalently essential to understand the pathological interactions. It has been studied already that recurrent urinary tract infection and gliosis of basal ganglia is linked with acute and sometime persistent psychosis [6]. Such link has also been evident in population study presented in this research.…”

Microbial Translocation Disorders: Assigning an Etiology to Idiopathic Illnesses

“…Along this line of thought, IBD and CRC, conditions characterized by increased intestinal permeability and MT appear to validate Kraepelin's migration model [216][217][218]. The same can be stated about psychosis induced by urinary tract infections (UTI), a destabilizing condition in patients with psychiatric illness [219][220][221] (next subsection). Moreover, Kraepelin's paradigm appears to be validated by the link between maternal influenza and offspring with schizophrenia, or childhood viral enteritis, and the development of psychiatric illness later in life [222][223][224][225].…”