Urosepsis

Urosepsis

Urosepsis is a systemic inflammatory reaction of the entire organism as a result of a bacterial infection originating in the urinary tract. With an incidence of 3 in 1000, urosepsis leads to a severe septic disease which is extremely life-threatening with a mortality rate of 50 to 70 percent.

What is urosepsis?

Urosepsis is a systemic inflammatory reaction of the organism, which starts from an infection of the urinary tract and is usually due to an obstruction of the urine flow. For meige syndrome explained, please visit psyknowhow.com.

As a result of colonization of the bloodstream by bacterial pathogens of the urogenital tract, the germs enter the affected person’s blood system and trigger the symptoms characteristic of urosepsis.

The first signs of urosepsis are fever, chills, a general feeling of illness and pain. In addition, tachycardia (palpitations), tachypnea (increased respiratory rate), hypotension (low blood pressure), cyanosis (livid skin discoloration) and oliguria (reduced urine production) are characteristic symptoms of urosepsis. In addition, in the advanced stage of urosepsis, the affected person may become increasingly clouded in consciousness.

Causes

Urosepsis is due to a bacterial infection with toxins (poisons) forming pathogens of the urogenital tract such as Escherichia coli (over 50 percent), Klebsiella, Enterobacter or Proteus.

Here, the bacterial pathogens penetrate the urinary tract into the bloodstream and cause sepsis (“blood poisoning”). The toxins formed by the bacteria or dead bacteria cause damage to the endothelium (vascular skin) and a systemic inflammatory reaction of the entire organism.

Favoring factors for this process are, in particular, urinary outflow disorders (prostatic hyperplasia, ureteral stenosis, ureteral stones, congenital strictures), as a result of which a backwater occurs, which facilitates the passage of the pathogens into the bloodstream.

Drug therapies with immunosuppressants (including chemotherapy), diabetes mellitus, malignant tumors (ureteral tumor), cirrhosis of the liver and kidney or prostate abscesses, inflammation of the renal pelvis and delayed pathogen invasion after endoscopic interventions are other factors that can promote urosepsis.

Symptoms, Ailments & Signs

Due to the systemic infection of the human body, urosepsis closely resembles blood poisoning. These include rapid onset of flu symptoms such as chills, intense exhaustion and sudden fever. Another similarity with septic shock is a warm-looking skin that later turns bluish.

This cyanosis (blue addiction) is particularly noticeable on the lips. Narrowing of the veins leads to cold finger and toe tips. As a result, the heart reacts to the physical state of emergency with tachycardia. In combination with complete absence and apathy, this symptomatology indicates a serious emergency with a life-threatening condition for the victim.

Patients generally suffer from an increased respiratory rate and a noticeable drop in blood pressure values. However, there are also individual characteristics that are not consistent with classic sepsis. Urosepsis causes severe pain in the region of the urinary and genital organs. Blockages in the flow of urine and noticeably small amounts of urine when going to the toilet suggest a difficult inflammatory process.

However, these symptoms are not necessarily associated with a life-threatening septic shock. The suspicion already provides sufficient reason for a detailed examination of a patient. Urosepsis is always considered a potentially fatal complication of bacterial infections. If there is no rescue therapy or if it only takes place at a later stage, the chances of survival drop dramatically. A circulatory collapse resulting in death due to multi-organ failure is then unavoidable in many cases.

Diagnosis & History

Urosepsis is diagnosed based on the characteristic symptoms. In addition, the determination of the cause and the identification of the focal point are the focus of the diagnosis.

For example, urinary obstruction or [kidney abscess]] can be detected on the basis of an ultrasound scan. A blood analysis can show leukocytosis (increased number of leukocytes) or, later on, leukocytopenia (low number of leukocytes) and thrombocytopenia (low number of thrombocytes), which leads to pronounced coagulation disorders.

If there is an increased procalcitonin value (over 10 ng/ml), which acts as a sepsis marker, the diagnosis is considered to be confirmed. The specific pathogen can be determined via a blood culture. The vital parameters (pulse, respiratory rate, urine output, blood pressure, vigilance) are important indicators for the prognosis and initiation of intensive care measures.

The prognosis and course of urosepsis depend significantly on the time of diagnosis and the start of therapy. If left untreated, urosepsis leads to septic shock, which is accompanied by multi-organ failure and has a high probability (50 to 70 percent) of death.

Complications

Urosepsis can cause various health problems over time. A typical complication of acute bacterial infection is the failure of organ functions. Initially, however, urosepsis causes less serious complications.

Those affected suffer, for example, from fever and cardiovascular problems which, if left untreated, can lead to circulatory collapse, heart failure and other complications. The loss of fluid can lead to dehydration and, as a result, to impaired consciousness and ultimately to dehydration. If urosepsis progresses further, complete blood poisoning can occur.

Then the general condition of the affected person deteriorates rapidly and multi-organ failure, septic colonization in the brain and other life-threatening complications occur. Complications can also occur in the treatment of urosepsis. If antibiotics are prescribed to patients, there is always a risk of side effects, such as headaches, muscle and body aches, gastrointestinal problems and skin irritations.

In the case of an overdose or prolonged use, the drug can cause permanent organ damage. Any previous illnesses or concomitantly taken medication can lead to interactions. If a catheter or a ureteral splint is placed, this can promote inflammation and larger infections. Injuries to the surrounding tissue structures are also possible.

When should you go to the doctor?

Immediate treatment by a doctor is necessary for urosepsis. In the worst case, this disease can even lead to the death of the patient, so that the person affected should consult a doctor at the first signs and symptoms of the disease. The earlier urosepsis is recognized and treated, the better the further course is in most cases.

A doctor should be consulted if the patient suffers from a very high and severe fever and also from chills. The fever does not go away on its own and cannot be reduced with medication. In many cases, those affected are very tired and listless and can no longer participate in everyday life. Furthermore, a very small amount of urine when urinating can indicate urosepsis and should be examined by a doctor.

This disease is usually evaluated and treated by a urologist . Complete healing cannot be universally predicted.

Treatment & Therapy

As a rule, urosepsis is caused on the one hand and treated on the other hand as part of antibiotic therapy. Depending on the underlying cause of the disease, this may require surgery in the area of ​​the urogenital tract. If, for example, there is a urinary blockage, this can be corrected with a retrograde ureteral splint, within which a thin catheter is guided to drain the urine from the renal pelvis into the affected ureter.

In addition, if there are no coagulation disorders, a percutaneous nephrostomy (renal fistula) can be used to remove the obstruction. For this purpose, the urine accumulated in the renal pelvis is drained to the outside via a small tube. If urosepsis is accompanied by abscesses, which can be present in pyelonephritis (inflammation of the kidneys), prostatitis (inflammation of the prostate) or epididymitis ( inflammation of the epididymis ), these are also drained via a puncture or mini-incision for relief.

Even before the evaluation of the pathogen culture, a calculated antibiotic therapy (cephalosporins, aminoglycosides, fluoroquinolones, carbapenems, acylaminopencilline) is started, which is then adapted to the antibiogram (resistance determination) or the specific pathogens present.

In addition, the circulation should be stabilized by hypercolloidal infusions (plasma expanders) that counteract the loss of volume. Infusion therapy also compensates for the fluid balance and promotes urination. A derailment of the acid-base balance can be compensated with the help of hydrogen carbonates.

If there is no improvement in the symptoms, intensive care measures to treat the urosepsis and, in the case of organ failure, ventilation and hemofiltration (kidney replacement therapy) may be necessary.

Prevention

Urosepsis can be prevented by early diagnosis and timely start of therapy, as well as consistent treatment of the underlying disease.

Aftercare

The aftercare of urosepsis must be carried out very conscientiously by a specialist doctor. Urosepsis is a potentially life-threatening complication caused by bacteria – originally in the urogenital tract – which have entered the bloodstream. Depending on the course of the urosepsis, the healing and recovery is different and individual.

If urosepsis can be treated early with antibiotics and stabilizing measures, it can ultimately be assumed that the person affected will be completely cured. Long-term follow-up care is therefore not to be expected once the treatment has been completed. The specialist must ensure that all the bacteria in the bloodstream have disappeared so that the urosepsis cannot flare up again due to the renewed multiplication of the remaining bacteria.

The general condition of the patient can still be weak in the first time after the urosepsis, this should be observed and, if necessary, treated with support and in cooperation with the family doctor responsible for the person concerned. A certain recovery time after urosepsis is important in order to stabilize the patient’s general condition as best as possible.

If the urosepsis can be treated without complications, no long-term damage can be assumed and no drug or other invasive therapy is required in the aftercare.

You can do that yourself

At the latest when this diagnosis is suspected, the affected patient should be admitted to the nearest hospital immediately. Sepsis – blood poisoning – is always a life-threatening disease that cannot be cured with simple home remedies. It doesn’t matter where the pathogens got into the bloodstream from, as in this case from the urinary tract.

As soon as patients have problems urinating and only excrete a little liquid, medical advice is indicated. Although these problems do not have to, they can lead to life-threatening urosepsis. The relatives of the affected patient should also keep an eye on the course of the disease, because urosepsis in the early stages can also lead to apathy and listlessness. The sick are then no longer able to call the emergency doctor themselves and to be admitted to a hospital.

As a rule, an antibiotic is prescribed to treat urosepsis, which must be taken even after the immediate danger to life has passed. Other medical measures such as surgery, infusion therapy or even dialysis must also be approved.

In addition, the patient should ensure adequate hygiene during the convalescence period to avoid reinfection. A healthy lifestyle helps the body to survive the serious illness. This includes adequate sleep as well as a diet rich in vitamins but low in fat.

Urosepsis