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Sometimes, if a UTI is left untreated, the bacteria that causes it can enter your bloodstream, causing what is called urosepsis. In this article, we will discuss the risk factors, causes, types, symptoms, diagnosis and treatment of urosepsis.
◉ What is urosepsis?
Urosepsis is one of the serious possible complications of poorly or untreated urinary tract infections. It is defined as the spread of a UTI beyond the urinary tract, reaching the bloodstream and causing sepsis.
Urosepsis can originate in any part of the urinary tree:
- Urethritis: Infection of the urethra, the tube that carries urine from the bladder to the outside of the body.
- Cystitis: bladder infection.
- Ureteritis: infection of the ureters, which are thin tubes that connect the kidneys to the bladder.
- Pyelonephritis: an infection that affects the kidneys.
Once established, urosepsis can quickly progress to a life-threatening condition. That is why it is essential to treat this disease urgently.
◉ Causes
Urosepsis is a form of sepsis arising from the urogenital tract. It is therefore the consequence of a urinary tract infection and one or more factors favoring the proliferation and spread of bacteria.
According to Avital et al, Escherichia coli is implicated in 50% of urosepsis cases, followed by Proteus (15%), Enterobacter (15%), Klebsiella (15%), and Pseudomonas aeruginosa (5 %).
◉ Risk factors for urosepsis
- Untreated urinary tract infections.
- Infections caused by resistant bacteria.
- Recurrent urinary tract infections.
- A urinary obstruction, whether due to a kidney stone, a tumor, enlarged prostate or other causes, may promote stagnation of urine.
- A weakened immune system.
- Congenital anomalies of the urinary tract.
- Use of urinary catheters.
- Diabetes.
- Advanced age.
◉ Symptoms of urosepsis
Les symptômes de l'urosepsie sont généralement précédés par les symptômes d'une infection urinaire.
- Frequent need to urinate.
- Burning sensation during urination.
- Painful urination (dysuria).
- Cloudy or dark urine.
- Blood in the urine.
- Pelvic pressure or discomfort.
- Fatigue or general malaise.
- Feeling that your bladder has not completely emptied.
- Back or flank pain: Infections that have spread to the kidneys can lead to pain in the back, sides, or lower abdomen.
If the urinary tract infection is left untreated or if it spreads to other parts of the urinary system, it can progress to urosepsis.
- High or low body temperature.
- Nausea and vomiting
- Rapid breathing and difficulty breathing.
- Fast heart rate.
- Low blood pressure.
- Decreased urine output.
- Extreme fatigue.
Note: If you experience any of these symptoms, please see your doctor promptly.
◉ Complications
Urosepsis is a serious medical condition, and getting prompt treatment is crucial to avoiding life-threatening complications. These complications may include:
- Kidney damage is a common result and can lead to impaired kidney function or chronic kidney disease.
- Organ failure.
- Abscess formation.
- Septic shock, characterized by very low blood pressure, endangering the blood supply to vital organs.
- Without prompt and proper medical attention, urosepsis can lead to death.
◉ Diagnosis
Pour diagnostiquer une urosepsie, le médecin suit généralement plusieurs étapes complémentaires, qui peuvent inclure:
- Interrogation: The doctor takes a complete medical history and asks questions about the patient's symptoms.
- Physical examination: The doctor performs a physical examination to assess the patient's general condition, including blood pressure, heart rate, body temperature, and looks for signs of pain or discomfort. abdominal tenderness.
- Blood tests: Blood tests, such as complete blood count (CBC), CRP, sedimentation-rate and the measurement of creatinine levels, can be carried out to assess the inflammation, infection and kidney function.
- Urinalysis: This is performed to look for signs of urinary tract infection, such as the presence of leukocytes (leukocyte esterase), the presence of nitrites and other indicators of infection.
In order to confirm the diagnosis, it is essential to isolate the causative organism. If the same germ is found in blood and urine, this has great diagnostic value:
- Blood culture: Aims to identify the presence of a pathogenic microorganism (bacterium or fungus) in the patient's blood.
- Uroculture: Aims to identify the presence of a pathogenic microorganism in the patient's urine.
- Imaging tests, such as ultrasound and computed tomography (CT scan), may be done to assess the condition of organs, look for malformations or abscesses that may require interventions additional medical.
◉ Treatment
Treatment for urosepsis is usually a medical emergency and may include the following:
- Patients with urosepsis are usually hospitalized for intensive monitoring and treatment.
- Antibiotic treatment: Consists of the administration of broad-spectrum antibiotics to fight the infection. This treatment can then be adjusted based on the results of bacterial identification and sensitivity testing
- Treatment of the infectious site: If urosepsis is due to a specific underlying cause, such as a kidney stone or abscess, specific medical or surgical intervention may be necessary.
- Intravenous (IV) Filling: The patient may receive intravenous administration of fluids to maintain blood pressure and ensure adequate hydration.
- If necessary, oxygen administration can be implemented to ensure adequate oxygenation of the body.
- Vasoactive drugs: Vasoactive drugs may be administered to stabilize blood pressure and maintain adequate blood flow.
◉ Prevention
Urosepsis prevention involves reducing the risk of urinary tract infections and managing risk factors.
- Adequate hydration.
- Proper hygiene practices: Wipe front to back after using the toilet, wash your hands before and after using the toilet, and maintain good general bathroom hygiene.
- Regular emptying of the bladder.
- Urinating after sexual activity.
- Follow proper hygiene protocols and care if you have a catheter.
- Rapid treatment of urinary infections to prevent their progression to urosepsis.
- Choice of cotton underwear to reduce humidity and promote better air circulation.
Note: Prevention plays an essential role in avoiding serious complications and complex and heavy treatments.
◉ Conclusion
urosepsis is a serious condition that results from the spread of a urinary tract infection into the bloodstream. It can have various origins in the urinary tree and requires rapid diagnosis and appropriate treatment to avoid serious or even fatal complications.
Early treatment remains the key to ensuring a better outcome in cases of urosepsis.