Hyperammonemia is a crucial differential diagnosis leading to consciousness disorders. While it is often associated with liver failure in most cases, it is imperative to be aware that hyperammonemia can also be induced by rare urease-producing bacteria, such as causing obstructive urinary tract infections, as seen in this case. We report the case of an 85-year-old woman with no history of liver dysfunction and no previous indications of voiding difficulties.
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