This article uses a brief case report to illustrate the options available to physicians when faced with a patient with asymptomatic bacteriuria. The patient was a 74-year-old woman who had been symptomatic of fatigue and malaise for 3 weeks and had problems with urinary incontinence when coughing or lifting heavy objects. Urine microscopy showed bacteriuria despite the absence of signs of urinary tract infection. The clinical significance of bacteriuria is defined as > 100,000 colony-forming units per milliliter of urine. Available tests for bacteriuria include microscopy, test strip analysis, and urine culture. Urine testing for infection is considered appropriate when there are signs of urinary tract infection or clinical features of systemic sepsis. In pregnant women, testing and treatment of asymptomatic bacteriuria can reduce the risk of pyelonephritis in pregnant women in the second trimester by 75%. Testing and treatment for bacteriuria is not recommended for children, diabetic women, or women with stable stress incontinence when there are no clinical signs of urinary tract infection or systemic infection. It is also not recommended for individuals who have been using catheters for prolonged urinary catheterization without other symptoms (fever, new-onset delirium, chills, and new-onset costovertebral angle tenderness). Since treatment with antimicrobials can disrupt the normal microflora and lead to a number of other diseases, such as mucocutaneous candidiasis, narrow-spectrum antimicrobials should be chosen for treatment. In the case of the patient in the above scenario, we decided to study his urinary incontinence. Although E. coli was found to be susceptible to specific antibiotics, the problem of fatigue resolved on its own and hence was not treated with antibiotics.