Urosepsis is a combination of medical terms urology, the function of the urinary system, and sepsis, a life-threatening bacterial infection. Urosepsis is a severe infection that is localized in the urinary tract and has the potential to be fatal.
The urinary tract consists of the kidneys, ureters, bladder, and urethra. The job of the kidneys is to filter blood, extracting all waste products from the urine. When an infection of this system occurs, it can lead to many of the symptoms associated with a urinary tract infection. If it is not remedied in a prompt manner, the infection may travel up the urinary tract to the kidney. This leads to further infection and the development of urosepsis, which is when the infection reaches the bloodstream.
What causes urosepsis?
It is known that infections of the urinary tract occur when an infectious organism travels up the urethra. Women more commonly face urinary tract infections as a result, owing to their shorter urethras compared to men. If a urinary tract infection were to spread into the blood, urosepsis has occurred. The following are specific causes leading to the condition:
- Use of an indwelling catheter: Commonly used in hospital settings and in those unable to use the bathroom, a catheter is a tube that’s inserted through the urethra that empties the bladder into a bag. Improper emptying of this bag may cause microorganisms to ascend through the catheter, leading to infection.
- Benign prostatic hyperplasia (BPH): The enlargement of the prostate can impede urine flow. Urine accumulating in the bladder may lead to microorganism growth.
- Kidney stones: Blockage of urine through the ureter or any other structure of the urinary system can lead to the promotion of bacteria growth.
- Urinary tract infection by E. coli: A common bacterium found in our gastrointestinal tract. It has the potential for spreading.
- Sexually transmitted diseases: Chlamydia infection may lead to the development of urosepsis.
While not direct causes, certain conditions can cause urinary tract infections, leading to urosepsis. They are:
- Diabetes mellitus
- Immunocompromised states
- Advanced age
- Female gender
- Fecal incontinence
- Incomplete bladder emptying
What are urosepsis signs and symptoms?
Prior to development, the typical signs and symptoms of a urinary tract infection are experienced. They may be:
- Cloudy urine
- Difficult or painful urination, or burning with urination (dysuria)
- Fever and chills
- Foul-smelling urine
- Frequent urination
- General ill feeling
- Pain during sexual intercourse
- Urgent need to urinate
When the symptoms get out of hand and spread, it can lead to the development of urosepsis. This life-threatening condition can present with the following symptoms:
- Change in level of consciousness or alertness
- High fever (greater than 101F)
- Inability to produce urine
- Profuse sweating and unusual anxiety
- Tachycardia—rapid heart rate
- Shortness of breath or difficulty breathing
- Severe abdominal, pelvic, or back pain
- Severe nausea and vomiting
- Weak pulse
Diagnosing and treating urosepsis
Sepsis patients are considered to be in critical status. Much of the treatment focuses on early recognition of symptoms to improve outcomes. Treatment is often dependent on time and typically includes supportive measures and the use of broad-spectrum antibiotics. Eradicating the bacterial infection is the main objective in of treatment.
Typical management of urosepsis involves the following treatment:
- IV fluids
- Oxygen therapy
- Vasopressor drugs to increase blood pressure
- Mechanical ventilation
- Blood transfusions