Urosepsis: What to know about UTI complications
Urosepsis is a serious complication of a urinary tract infection (UTI) that requires immediate medical care to avoid a possible life-threatening event. Anyone experiencing the symptoms of urosepsis should seek emergency medical attention.
Symptoms of urosepsis include pain near the kidneys on the lower sides of the back.
Because urosepsis is a complication of a UTI, most people with the condition are likely to have symptoms of a UTI already.
The most common UTIs are bladder infections, and symptoms include:
- frequent urges to urinate
- a burning or itching sensation while urinating
- feeling that the bladder is full, even after urinating
- cloudy urine
- blood in the urine
- foul-smelling urine
- pain during sex
- pressure in the lower back or lower abdomen
- malaise, or a feeling of being generally unwell
If the infection spreads beyond the bladder, it can reach the higher parts of the urinary system, such as the kidneys and ureters. When the infection reaches these areas, urosepsis is one possible complication.
In addition to UTI symptoms, people with urosepsis may also display more serious symptoms common to other forms of sepsis. Anyone experiencing these symptoms should seek immediate medical care.
Symptoms of urosepsis include:
- pain near the kidneys, on the lower sides of the back
- nausea with or without vomiting
- extreme fatigue
- reduced urine volume or no urine
- trouble breathing or rapid breathing
- confusion or brain fog
- unusual anxiety levels
- changes in heart rate, such as palpitations or a rapid heartbeat
- weak pulse
- high fever or low body temperature
- profuse sweating
In some serious cases, urosepsis may progress to severe sepsis, septic shock, or multi-organ failure.
People with severe sepsis produce little to no urine. They may have difficulty breathing, and their heart may have difficulty functioning.
During septic shock, a person's blood pressure drops to extremely low levels, and their organs may shut down. These symptoms are life-threatening and require immediate medical attention.
A UTI can occur if bacteria enter through the urethra, which is the tube that urine travels through to exit the body. These bacteria may reach the urethra in a variety of different ways, including through sexual contact, inadequate personal hygiene, or a pre-existing bladder condition. Women are more prone to UTIs than men because their urethras are shorter than a man's.
The bacteria can spread from the urethra into the bladder, where they can multiply, causing an infection. If a UTI is left untreated, it can lead to complications, such as urosepsis.
Sometimes, UTIs develop because bacteria that are already present in the bladder have multiplied to an unhealthy level.
Some people, including women and older adults, are at greater risk of developing urosepsis. Also, people with open wounds or devices, such as catheters or breathing tubes, may also be more at risk of getting infections and UTIs, which can increase the risk for urosepsis.
Other risk factors for urosepsis include:
- being over 65 years old
- a compromised immune system from autoimmune disorders such as HIV or AIDS
- immunosuppression from certain drugs, organ transplant, or chemotherapy
- corticosteroid treatment
- history of urinary conditions
- catheter use
Emergency medical attention is needed for the symptoms of urosepsis.
Not everyone treated for urosepsis will have complications, especially if the condition is treated promptly and effectively.
Possible complications of urosepsis include:
- collections of pus near the kidneys or prostate
- organ failure
- kidney damage
- scar tissue in the urinary tract
- septic shock
Treating urosepsis early and following the doctor's treatment plan are crucial steps to avoid complications.
A doctor may diagnose urosepsis after confirming that the person has a UTI, which is done through a simple urine sample. If a UTI has been left untreated or the doctor thinks the infection may have spread, they may order immediate blood tests to help diagnose urosepsis.
The doctor may also look for another source of infection that is causing sepsis by using a chest X-ray to look at the lungs, or a blood culture to look for bacteria in the bloodstream. Sometimes, a doctor may examine the skin for rashes or ulcerations.
Doctors may also perform other imaging tests. A computerized tomography (CT) scan of the abdomen and kidney can help form a complete picture of the kidney. An ultrasound scan may also help doctors see into the urinary tract to diagnose urosepsis.
If caught early, UTIs are easy to treat with antibiotics. A person with a UTI also needs to drink plenty of fluids to help flush the urinary tract.
However, treating urosepsis is not as simple, because it may not respond to antibiotics alone. A doctor will likely start the treatment with antibiotics because it is essential to treat the bacteria that caused the original UTI.
Doctors will monitor a person closely to see how well they respond to the antibiotics. If a person has severe sepsis or septic shock, they may require oxygen.
Some people will need surgery to get rid of the source of an untreated infection completely.
Doctors may prescribe vasopressors, which constrict the blood vessels and increase a person's blood pressure to keep their organs from shutting down due to septic shock.
If urosepsis is not treated quickly, the person may require emergency hospitalization in the intensive care unit (ICU). If urosepsis progresses and the person develops septic shock, they will need emergency medical treatment.
Washing the hands before and after using the toilet is recommended to help prevent UTIs.
As urosepsis is often the result of an untreated UTI, it is essential to prevent UTIs wherever possible.
There are a variety of steps a person can take to help prevent UTIs, including:
- wiping from front to back after using the toilet
- washing the hands before and after using the toilet
- wearing cotton underwear
- drinking plenty of water daily
- urinating immediately after sexual activity
- not waiting longer than necessary to urinate
Anyone experiencing signs of a UTI should visit their doctor for diagnosis and treatment. A prompt diagnosis and treatment is key to avoiding complications.
Urosepsis is a serious, potentially deadly complication of a UTI. Knowing about the signs and symptoms may help people understand the importance of getting prompt treatment for infections.
Anyone who thinks they have a UTI or other problem with their urinary tract should seek medical care.