Question: 41. EXTRA CREDIT: An 85-year-old Woman With A History Of High Blood Pressure, Kidney Disease, And Diabetes Is Transferred From A Nursing Home To A Hospital With A Fever And Altered Mental Status. Laboratory Data Reveals The Following: Amylase, Lipase, AST, ALT, GGT, And Bilirubin Are Within Normal Limits. Results Of A Urinalysis Reveal: Specific Gravity …

41. EXTRA CREDIT: An 85-year-old woman with a history of high blood pressure, kidney disease, and diabetes is transferred from a nursing home to a hospital with a fever and altered mental status. Laboratory data reveals the following: Amylase, lipase, AST, ALT, GGT, and bilirubin are within normal limits. Results of a urinalysis reveal: Specific gravity = 1.01 (normal 1.002 – 1.03); protein = 200 mg/dL (normal 30 – 130mg/ dL); WBC = 50/hpf (normal 0 – 5/hpf); keynotes = positive; crystals = negative; casts = negative; nitrite = negative; leukocyte esterase = positive. CXR and abdominal ultrasound are noncontributory. Based on your assessment of the patient and laboratory tests, indicate the most likely reason for the hospital admission in this patient. Explain.