Dorothy FarrarUrosepsis
Urosepsis is an acute infection caused by strains of bacteria that enter the bloodstream from the urogenital tract . In addition to the classic symptoms of sepsis, urosepsis can also cause pain in the area of the kidneys and the urinary organs as well as urinary drainage disorders.
What is urosepsis?
Urosepsis is a severe infection that originates in the urinary tract and, if left untreated, can quickly lead to shock and death of the patient. Sepsis (colloquially also referred to as blood poisoning ) is caused by (mostly gram-negative) bacteria , which usually enter the blood through urinary retention in the urogenital tract and unfold their sometimes life-threatening toxic effects there. The most dangerous complication of urosepsis is the failure of organ functions.
Due to the fact that the disease, which is often life-threatening if left untreated, the rapid initiation of a targeted therapy with antibiotics and the immediate elimination of any triggering foci of disease in the body are essential in order to prevent the urosepsis from progressing.
causes
There are many possible causes for the development of life-threatening urosepsis. The trigger is often an existing urological disease. Classic causes of urosepsis are an obstruction of the urinary tract (e.g. due to bladder stones , a ureteral stone, an enlarged prostate or a tumour), which impedes the physiological outflow of urine, as well as abscesses of the kidneys or the prostate.
Inflammation (e.g. of the renal pelvis , kidneys , bladder or epididymis ) or bladder emptying disorders are also among the triggers of urosepsis. If an endoscopic procedure preceded the onset of the disease, an undesirable colonization of germs that promote sepsis must also be considered.
In addition, there are certain groups of people who have an increased risk of urosepsis due to existing diseases: These are primarily patients with diabetes mellitus , tuberculosis or cancer, especially if they are particularly immunocompromised due to chemotherapy . Older people are also more likely to suffer from urosepsis.
symptoms and course
Possible signs of hydronephrosis:
- tachypnea (rapid breathing)
In most cases, urosepsis shows up in the classic symptom complex of sepsis (blood poisoning). These are flu-like symptoms that often appear suddenly, such as fever, chills and a pronounced feeling of illness. Also typical of sepsis are an increased heart rate ( tachycardia ), accelerated breathing (tachyapnea) and a drop in blood pressure (hypotension). In the case of cyanosis , a bluish discoloration of the lips, mucous membranes and fingernails, as well as increasing apathy in the patient, an advanced and therefore potentially threatening stage of (uro)sepsis must always be considered.
In addition to the general symptoms of sepsis, there are additional specific signs of urosepsis. This can primarily be pain in the area of the urogenital organs, urinary outflow disorders or a noticeably low amount of urine ( oliguria ). In the case of all suspected symptoms of urosepsis, which do not necessarily have to occur all together, an appropriate diagnosis and, if necessary, therapy must be initiated immediately, since urosepsis is a clinical picture, the course of which often leads to death if treatment is missing or initiated too late caused by multi-organ failure .
Diagnose
The first step in diagnosing urosepsis is a comprehensive anamnesis, which, in addition to recording the acute symptoms, also includes specific inquiries about past or existing diseases, especially in the area of the urogenital tract, or about recent endoscopic examinations.
In the context of laboratory diagnostics (blood and urine analysis), disorders of blood coagulation, abnormal leukocyte values - initially the pathological increase ( leucocytosis ), later the drop to very low levels ( leukopenia ) -, the lack of blood platelets ( thrombopenia ) and of course the triggering bacteria themselves classic for urosepsis. Elevated levels of creatinine and urea, which can indicate the onset of kidney failure, are also typical.
In addition to anamnesis and laboratory diagnostics, a third complex of examinations is the search for possible foci in the body that may have triggered urosepsis. Here, attempts are made to use sonography and other imaging methods such as computed tomography to trace the causes of infection that are responsible for the development of urosepsis.
treatment and therapy
In the treatment of urosepsis in severe clinical pictures (e.g. shock symptoms or imminent organ failure), intensive medical monitoring and stabilization of the patient is the priority. Once the pathogen has been precisely identified, the bacteria that cause sepsis are combated with a targeted administration of antibiotics . With regard to the bacterial strains that have been detected, any resistance that may arise must also be taken into account.
Just as important as the antibiotic treatment of pathogens in urosepsis is the rapid elimination of the triggering causes, since this is the only way to achieve permanent freedom from bacteria.
As part of a consistent focus remediation, for example, abscess formations in the urogenital tract must be treated with drainage or surgically removed. In the case of urinary flow disorders, the cause must also be treated as quickly as possible in parallel with antibiotic treatment – for example with a catheter or the placement of ureteral stents.
If urosepsis is the result of poorly controlled diabetes or in patients with impaired immune system performance, the treatment is supplemented by measures tailored to the individual patient to adjust the blood sugar level adequately or to improve their general condition.
prevention
Since in many cases urosepsis develops on the basis of an existing underlying disease, its early diagnosis and adequate therapy is also the best way to avoid sepsis. In addition, absolute sterility must be ensured during endoscopic interventions. Prophylaxis of diseases that can promote urosepsis is also useful. For example, a healthy diet can reduce the risk of kidney or bladder stones forming, while consistent hygiene and drinking enough can reduce the occurrence of bladder infections , which can also trigger urosepsis.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.