Urosepsis

Urosepsis is a severe illness that occurs when an infection starts in the urinary tract and spreads into the bloodstream. Urosepsis can be life-threatening if it is not treated immediately.

CAUSES

A urinary tract infection typically begins after bacteria get into the bladder. The bacteria get there through the opening in the bottom of the bladder (urethra). An infection in only the bladder is called cystitis. If the infection spreads to the kidneys, it is called pyelonephritis. Pyelonephritis is a more severe illness than cystitis. Urosepsis is a complication that occurs in some people who have pyelonephritis.

It is not known why a urinary tract infection in some people spreads into the bloodstream. Factors that increase your risk for developing urosepsis include:

  • Advanced age.

  • Diabetes.

  • Weakened immune system, such as from chemotherapy.

  • Kidney stones.

  • Having a tube used to drain urine from the bladder (Foley catheter).

  • Having a recent bladder test (cystoscopy).

SYMPTOMS

Symptoms of urosepsis can include:

  • Fever or low body temperature (hypothermia).

  • Rapid breathing (hyperventilation).

  • Chills.

  • Rapid heartbeat (tachycardia).

You may also have typical symptoms of a urinary tract infection, such as:

  • Pain with urination.

  • Difficulty urinating.

  • Frequent urination.

  • Pain in your side.

When sepsis is severe, low blood pressure and decreased oxygen flow to your vital organs may also occur. This is called shock.

DIAGNOSIS

Your caregiver may suspect urosepsis based on your history and a physical exam. Urine and blood tests may be done. Other tests, such as X-rays, ultrasound exams, or a CT scan may be used to determine the severity of your condition.

TREATMENT

Treatment requires a stay in the hospital. If you have severe sepsis, care is provided in an intensive care unit (ICU). Urosepsis requires prompt treatment with antibiotic medicines. Intravenous (IV) fluids will be used to support your blood pressure. Sometimes, other strong medicines are used to raise your blood pressure if necessary. Medicines can also be used to control pain or nausea, if present.

HOME CARE INSTRUCTIONS

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Drink enough fluids to keep your urine clear or pale yellow. Cranberry juice is especially recommended, in addition to water.

  • Increase your activity as tolerated, but get plenty of rest.

  • Keep all follow-up appointments with your caregiver for checkups and any tests.

  • Avoid caffeine, tea, and carbonated beverages. They can irritate the bladder.

  • Avoid alcohol. It may irritate the prostate, if this applies.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

PREVENTION

  • Empty your bladder often. Avoid holding urine for long periods of time.

  • After a bowel movement, women should wipe from front to back. Use each tissue only once.

  • Empty your bladder before and after sexual intercourse.

SEEK MEDICAL CARE IF:

  • You develop back pain.

  • You develop nausea or vomiting.

  • Your symptoms are not better after 3 days.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You feel lightheaded or develop shortness of breath.

  • You develop chills or a fever.

  • You are getting worse, not better.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.