Editing Urinary tract infection (section)

===Elderly===
Urinary tract symptoms are frequently lacking in the [[Old age|elderly]].<ref name=Elder2011/> The presentations may be vague and include incontinence, a [[Altered level of consciousness|change in mental status]], or fatigue as the only symptoms,<ref name=EM2011/> while some present to a health care provider with [[sepsis]], an infection of the blood, as the first symptoms.<ref name=Sal2011/> Diagnosis can be complicated by the fact that many elderly people have preexisting incontinence or [[dementia]].<ref name=Elder2011/>

It is reasonable to obtain a urine culture in those with signs of systemic infection that may be unable to report urinary symptoms, such as when advanced [[dementia]] is present.<ref name=AMDA2015>{{Citation |author1 = AMDA – The Society for Post-Acute and Long-Term Care Medicine |author1-link = AMDA – The Society for Post-Acute and Long-Term Care Medicine |date = February 2014 |title = Ten Things Physicians and Patients Should Question |publisher = AMDA – The Society for Post-Acute and Long-Term Care Medicine |work = [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |url = http://www.choosingwisely.org/doctor-patient-lists/amda/ |access-date = 20 April 2015 |url-status = live |archive-url = https://web.archive.org/web/20140913011101/http://www.choosingwisely.org/doctor-patient-lists/amda/ |archive-date = 13 September 2014 }}</ref> Systemic signs of infection include a [[fever]] or increase in temperature of more than {{convert|1.1|C-change|F-change}} from usual, chills, and an [[leukocytosis|increased white blood cell count]].<ref name=AMDA2015/>