Box 2. Guidance on diagnosis of UTI in frail
elderly women in nursing homes
Typical features may be absent in frail elderly women in nursing homes
(catheterized and non-catheterized), and it is important to exclude other sources
of infection. However, the presence of one of the following suggests a UTI:
■■ New costovertebral tenderness
■■ Rigors
■■ New onset delirium
■■ Fever greater than 37.9°C or 1.5°C above baseline
National Institute for Health and Care Excellence, 2013