Background: We present a case of severe neurological symptoms caused by hyperammonemia, secondary to a urinary tract infection with urea-splitting bacteria.
Investigations: Blood analysis, urinalysis, urine culture, abdominal ultrasonography, cystography, CT.
Diagnosis: Hyperammonemia as a result of urinary tract infection with urea-spliting bacteria.
Management: Desobstruction of the urinary tract and bladder or pouch rinsing, antibiotics, reduction of the dietary and endogenous nitrogen load, and endogenous nitrogen breakdown. Identification, prevention and treatment of underlying causes.