Expert: Paula Damgaard - 10/21/2004

Question
I recently lost my mother-in-law to alzheimer's. She developed a urinary tract infection which then went into sepsis. However, she never had much fever. Can you tell me why this happens?

Answer
Hi Patricia,  I am not sure what you are asking.  Why she got the urinary tract infection?  why sepsis? or why no fever?

As you probably know women are highly susceptible to urinary tract infections just because of the whole closeness of everything in that area.  Women who have had children also get more of them as they age due to the whole body "falling down"  the uterus helps to hold up the bladder and when that starts to atrophy, during menopause, the bladder starts to fall also.  So urine pools in the bladder.  This is a nice moist spot for bacteria to live in and they do!  75% of elderly women walk around with bladder infections and don't even know it.  With demented women we can usually tell they have one because it makes their dementia worse.  We send them for a urine test and there you go.  

If no one detects that the dementia is worse then the bacteria continues to brew in the bladder and large infections (of any kind) will cause a patient to become septic.  

Because the brain is shrinking and dying off the normal processed aren't occurring.  One of the areas that is affected is the area of the brain that would be stimulated to tell immune system to fight off the infection, therefore no fever.

I hope this answers what you are asking.  If not please feel free to ask again!  Paula