How a common infection becomes sepsis
With a urinary tract infection, bacteria and their waste products enter the bloodstream. If the immune system copes and urine flows freely, the process remains local.
But if the flow of urine is blocked—by a stone, a tumor, a stricture, an enlarged prostate—the infected urine is trapped in a confined space under pressure. Microorganisms and toxins enter the bloodstream massively, and the body responds with an excessive systemic reaction: blood vessels dilate, pressure drops, and blood supply to organs is disrupted.
That is why the basic principle of treatment is as follows: an antibiotic without drainage for obstruction is ineffective. While purulent urine is locked in the kidney, the drug simply cannot act in the lesion.
Who's at risk
- Patients with kidney and ureteral stones, especially those with obstruction
- People with installed stents and nephrostomies, including expired ones
- Men with prostate adenoma and chronic urinary retention
- Patients with an indwelling urethral catheter or cystostomy
- Patients with diabetes
- Elderly people
- Patients with immunodeficiency and after transplantation
- Pregnant women with pyelonephritis
- Patients after endoscopic surgery on the urinary tract
- People with a neurogenic bladder
How to recognize: warning signs
- Temperature above 38°C or drop below 36°C
- Increased heart rate and rapid breathing
- Systolic pressure is lower than usual, dizziness when standing up
- Confusion, lethargy, and unusual behavior are especially important signs in the elderly
- A sharp decrease in the amount of urine
- Pale, marbled, cool and dewy skin
- Marked weakness, inability to stand up
- Low back pain with chills in a person with known urolithiasis
- Nausea and vomiting, inability to drink
What to do immediately
- Вызвать скорую помощь или срочно доставить человека в стационар — это не ситуация для домашнего лечения
- Не пытаться сбить температуру и ждать до утра
- Не принимать антибиотик самостоятельно перед обращением — это затруднит посев и подбор терапии, но не решит проблему обструкции
- Сообщить врачу о камнях, стентах, нефростомах, перенесённых операциях и принимаемых препаратах
- Взять с собой имеющиеся снимки и выписки
Treatment
- Immediate initiation of broad-spectrum antibiotic therapy - in the first hours after culture collection
- Blood and urine cultures before antibiotic administration unless this delays treatment
- Massive infusion therapy to maintain pressure and blood supply to organs
- Blood pressure medications for septic shock
- Urgent drainage of the lesion is the most important step: ureteral stenting or percutaneous nephrostomy for obstruction
- Bladder catheterization or cystostomy for urinary retention
- Drainage of kidney abscess, paranephritis or prostate
- Treatment in the intensive care unit for severe cases
- Correction of therapy based on culture results
- Delayed stone removal - only after stabilization of the condition
Prevention
- Timely treatment of stones causing obstruction, without delaying “for later”
- Strict adherence to the timing of replacement and removal of stents and nephrostomas
- Treatment of prostate adenoma and chronic urinary retention
- Minimizing indwelling catheterization, proper catheter care
- Compensation for diabetes mellitus
- Full treatment of pyelonephritis and failure to complete the course is unacceptable
- Urine culture before planned endoscopic operations and sanitation of infection before intervention
- Immediate treatment of fever with low back pain in people at risk
Where to contact in Tashkent
Urosepsis is treated only in a hospital with a 24-hour laboratory, CT scanner, operating room and intensive care unit.
In Tashkent, such care, including emergency kidney drainage, is provided at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you have kidney stones or a stent installed, and you have a fever with chills, do not delay calling for an hour and be sure to tell your doctor about these circumstances. Clinic contacts are below on the page.
