Urinary Tract Infection Sepsis Symptoms

How Is It Diagnosed

Can a Urinary Tract Infection Cause Sepsis?

If doctors suspect that a UTI is present, they will test a urine sample in the office or send it to a laboratory for a urinalysis.

A urine culture can confirm which bacteria are causing the infection. Knowing the specific type of bacteria allows the doctor to determine a suitable treatment plan.

A condition called asymptomatic bacteriuria is also common in older adults. ASB occurs when there are bacteria in the urine, but they do not cause any signs or symptoms of infection.

Although ASB is common in older adults, it does not typically require treatment, unless it causes other clinical symptoms.

The standard treatment for a UTI is antibiotics, which kill the bacteria causing the infection. Doctors will prescribe an antifungal medication instead if a fungus is causing the UTI.

It is essential that people take the antibiotic or antifungal medication precisely according to the prescription, even if they begin to feel better. Completing the entire prescription will help to destroy all of the infectious bacteria.

Other Ways To Prevent Some Utis Coming Back

If you keep getting a bladder infection , there is some evidence it may be helpful to take:

D-mannose a sugar you can buy as a powder or tablets to take every day
cranberry products available as juice, tablets or capsules to take every day

Speak to your doctor before taking any of these during pregnancy.

Be aware that D-mannose and cranberry products can contain a lot of sugar.

If you’re taking warfarin, you should avoid cranberry products.

Page last reviewed: 22 March 2022 Next review due: 22 March 2025

Study Design And Population

This retrospective observational study was conducted between January 2006 and October 2018 at Chia-Yi Christian Hospital in southern Taiwan, which consists of 1,077 inpatient beds and an outpatient department serving approximately 4,110 patients per day. We evaluated patients with a clinical and microbiological diagnosis of UTI who required admission to our hospital. The study was conducted after obtaining ethical approval from the Institutional Review Board of Chiayi Christian Hospital .

The clinical characteristics and laboratory data including demographic characteristics , comorbidities , prior history of UTI, vital signs , laboratory results , clinical presentation , existence of urinary tract abnormality , admitted to Intensive Care Unit , length of hospital stay, antibiotic treatment, causative microorganisms, and antimicrobial resistance pattern were collected in a standard form for further analysis.

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What Are The Symptoms Of Sepsis

The following are the most common symptoms of sepsis. However, each person may experience symptoms differently.

People with sepsis often develop a hemorrhagic rasha cluster of tiny blood spots that look like pinpricks in the skin. If untreated, these gradually get bigger and begin to look like fresh bruises. These bruises then join together to form larger areas of purple skin damage and discoloration.

Lose interest in food and surroundings
Become feverish
Complain of extreme pain or discomfort
Feel cold, with cool hands and feet
Become lethargic, anxious, confused, or agitated
Experience a coma and sometimes death

Those who become ill more slowly may also develop some of the signs of meningitis. The symptoms of sepsis may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

Tuesday 14 January 2020

It was late on a Sunday night when Brisbane man Michael, 71, made a decision that possibly saved his life. Hed been feeling unwell for a couple of days and had seen his GP, who gave him antibiotics for a urinary tract infection.

Michael was told the medicine could make him feel unsteady, but now he was so dizzy he was having trouble getting out of bed. He needed to urinate but couldnt, and he was starting to feel more and more unwell. Michael was alone his wife was away in Sydney for a family event, and his adult children had all moved out of home.

He reasoned that he could go back to bed, try to sleep it off, and see how he felt in the morning. Or, he could ring an ambulance, tell them that he was getting concerned, his condition was deteriorating, and no one was with him. Michael chose the second option.

You know how the mind thinks when youre by yourself and its night time, says Michael. I thought to myself, I dont think I can keep going like this. I need medical help.

Michaels decision might have saved his life. He had sepsis, a life-threatening condition caused by an abnormal response from the body to an infection. A few hours later, while he was in hospital, Michaels organs began to shut down. He spent four days in the Intensive Care Unit and a total of seven days in hospital recovering. He went home with a course of strong antibiotics and spent the next few weeks slowly regaining his health.

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Pearls And Other Issues

Diagnostic Pitfalls

Urinary tract infections are primarily a clinical diagnosis, and expert opinion should be sought before initiating treatment of an isolated positive result in an otherwise asymptomatic patient, the only exception being asymptomatic bacteria.

Quite often, clinicians end up treating the positive culture report rather than a genuine urinary tract infection. Most often, a positive culture in an asymptomatic patient can be traced to poor sampling technique.

Another confusing scenario is that of a septic, delirious, elderly patient who is unable to provide a history or demonstrate adequate examination signs to help localize a septic source. Quite frequently, these patients are treated as having a presumed UTI in the absence of a clear alternative septic source.

UTI-associated radiological changes can sometimes take several months to resolve and must be interpreted with care in cases of recurrent or persistent infections.

UTI must be considered a differential diagnosis when evaluating a patient with a pelvic inflammatory disease or an acute abdomen.

Male patients with urinary tract infections should also be screened for sexually transmitted infections.

Interstitial cystitis is frequently misdiagnosed and treated as a UTI and must be considered as an alternative diagnosis in patients who keep presenting with cystitis symptoms without positive cultures.

Spinal cord injury patients with a UTI may present with increased spasticity or autonomic dysreflexia.

A Pharmacist Can Help With Utis

You can ask a pharmacist about treatments for a UTI.

A pharmacist can:

offer advice on things that can help you get better
suggest the best painkiller to take
tell you if you need to see a GP about your symptoms

Some pharmacies offer a UTI management service. They may be able to give antibiotics if they’re needed.

E Extremely Ill Severe Pain Or Discomfort Shortness Of Breath

Many sepsis survivors have said that when they were ill, it was the worst they ever felt. It was the worst sore throat, worst abdominal pain, or they felt that they were going to die.

Children developing sepsis may exhibit different symptoms, as seen below.

Healthcare professionals look for the following signs and symptoms, as well as those listed above, to determine a diagnosis. They include:

Nursing Care Plan For Urosepsis 2

Septic Shock: Treating Blood Infections, Pneumonia, Urinary Tract Infections

Hyperthermia

Nursing Diagnosis: Hyperthermia related to dehydration, the direct impact of circulating endotoxins on the hypothalamus, temperature regulation alteration, high metabolic rate, or infection secondary to urosepsis as evidenced by flushed skin that is hot to the touch, higher-than-normal body temperature, increased respiration rate, and palpitations.

Desired Outcomes:

The patient will not experience severe complications related to urosepsis.
The patientâs temperature will be within normal range and free of chills.

Tests To Diagnose Sepsis

temperature
breathing rate

Other tests can help determine the type of infection, where it’s located and which parts of the body have been affected. These include:

urine or stool samples
a wound culture where a small sample of tissue, skin or fluid is taken from the affected area for testing
respiratory secretion testing taking a sample of saliva, phlegm or mucus
blood pressure tests
imaging studies like an X-ray, ultrasound scan or computerised tomography scan

Urosepsis Nursing Care Plans Diagnosis And Interventions

Urosepsis NCLEX Review and Nursing Care Plans

Urosepsis emerges when an infection spreads from the urinary tract to the bloodstream. The bacteria can multiply from the urethra into the bladder, resulting in an infection. If a urinary tract infection is left untreated, it may result in complications, such as urosepsis.

UTIs can occur when bacteria in the bladder multiply to an alarming degree. Thus, urosepsis occurs when sepsis affects the urinary tract structures.

As the body tries to stop the infection, it can cause a drastic heartbeat, pyrexia, chills, confusion, organ damage, or even death. Recognizing the possible risks and clinical manifestations can be beneficial.

What Is A Urinary Tract Infection Exactly

A urinary tract infection is an infection of any part of your urinary system, which includes your kidneys, ureters, bladder, and urethra, according to the Mayo Clinic. Most UTIs involve the lower urinary tract, i.e. your bladder and urethra.

David Kaufman, MD, director of Central Park Urology, a division of Maiden Lane Medical, tells Health that while UTIs are much less common in men than women, they typically happen if a man has prostate enlargement, which can keep him from fully emptying his bladder.

“That can lead to a UTI because the urine in the bladder is sitting there like a cesspool,” Dr. Kaufman explains. When men develop a UTI, “it’s always considered a more complicated infection because it’s just more difficult for men to get UTIs,” he says.

Symptoms of a UTI can vary, but they usually include the following, per the Mayo Clinic:

A strong, persistent urge to pee
A burning sensation when you pee
Passing frequent, small amounts of urine
Urine that appears cloudy
Urine that appears red, bright pink, or cola-colored
Strong-smelling pee
Pelvic pain, in women, especially in the center of the pelvis and around the area of the pubic bone.

Symptoms Of Sepsis In Adults

Adults with sepsis might experience one or more of the following symptoms:

Fast breathing
Skin rash or clammy/sweaty skin
Weakness or aching muscles
Not passing much urine
Feeling very hot or cold, chills or shivering
Feeling confused, disoriented, or slurring your speech
Feeling very unwell, extreme pain or the worst ever.

Adults with sepsis might express that they feel like they are dying or that they have never been so sick and are worried about their health.

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What Causes A Sepsis Infection

The immune system usually keeps an infection limited to one place. This is called a localised infection. To do this, the body produces white blood cells.

White blood cells travel to an infection site to destroy the germs causing the infection. This triggers tissue swelling, known as inflammation. This helps to fight the infection and prevent it from spreading.

However, an infection can spread to other parts of the body if the immune system is weak or an infection is severe.

Widespread inflammation can damage tissue and interfere with blood flow. When blood flow is interrupted, blood pressure can drop dangerously low. This stops oxygen from reaching the organs and tissues.

Major Outcomes And Endpoints

The primary outcome was dichotomous. Patients were divided into two groups: cases with septic shock at time of admission or during hospitalization and cases without septic shock. We investigated patient’s underlying medical conditions with the potential to contribute to UTI mediated shock. These include underlying general condition and comorbidities , baseline kidney function, indwelling urinary tract catheter prior to UTI, AKI during hospitalization, and urosepsis. CAD was diagnosed by cardiologist according to resting and exercise electrocardiogram, echocardiography, radionuclide scans, and coronary angiography. CHF was diagnosed according to New York Heart Association Functional Classification. AKI were diagnosed with glomerular filtration rate decrease of more than 50% or doubling of serum creatinine during hospitalization compared to baseline renal function according to The RIFLE criteria, proposed by the Acute Dialysis Quality Initiative group . GFR was estimated based on serum creatinine and the Modification of Diet in Renal Disease equation. According to the KDOQI CKD classification, the stage of CKD was assigned based on the level of baseline kidney function and irrespective of diagnosis . Bacteremia is an invasion of the bloodstream by bacteria confirmed by blood culture. Comorbidities were obtained through medical chart review and patient interview.

Who Is Affected By Utis And How Are They Treated

Women are more commonly affected by them than men. Around half of women will need treatment for at least one UTI during their lifetime.

If treated with the right antibiotics, UTIs normally cause no further problems and the infection soon passes. Though complications are uncommon, they can be serious and include kidney damage and blood poisoning, which can be fatal.

Can I Become Immune To The Antibiotics Used To Treat A Uti

Influenza and Sepsis: Mayo Expert Describes Warning Signs of Severe Sepsis, Septic Shock

Your body can actually get used to the antibiotics typically used to treat a urinary tract infection . This happens in people who have very frequent infections. With each UTI and use of antibiotics to treat it, the infection adapts and becomes harder to fight. This is called an antibiotic-resistant infection. Because of this, your healthcare provider may suggest alternative treatments if you have frequent UTIs. These could include:

Waiting: Your provider may suggest that you watch your symptoms and wait. During this time, you may be encouraged to drink plenty of fluids in an effort to flush out your system.
Intravenous treatment: In some very complicated cases, where the UTI is resistant to antibiotics or the infection has moved to your kidneys, you may need to be treated in the hospital. The medicine will be given to you directly in your vein . Once youre home, you will be prescribed antibiotics for a period of time to fully get rid of the infection.

Escherichia Coli And Kidney Infection

The common harmful bacteria Escherichia coli are very frequently found to be the cause of pyelonephritis. These bacteria live in the bowels of healthy people, and through the urethra they could travel into the bladder and the ureters , causing infections of the lower urinary tract , such as cystitis or kidney infections.

Kidney infections may develop in patients without a prior bladder problem, especially due to the blockage of the kidneys and conditions such as enlarged prostate or kidney stones. Additionally, the infection may also come to your kidneys from some other part of the body.

I Infection May Have Signs And Symptoms Of An Infection

If you have a local infection, like a urinary tract infection, pneumonia, or an infected cut, the signs and symptoms are localized according to the area affected . If the infection has spread or you have a generalized infection, you may develop other signs and symptoms, such as fever, fatigue, pain, etc.

Sometimes however, you may have an infection and not know it, and not have any symptoms. Keep this in mind especially if you have recently had surgery or an invasive medical procedure, a break in your skin, or you have been exposed to someone who is ill.

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What Causes Urosepsis

Urosepsis starts with the development of a UTI. UTIs most often occur when bacteria enter your urinary tract through your urethra, the tube through which urine exits the body. Bacteria can get into the urethra commonly through sexual activity. The bacteria can get into your bladder, where they begin to multiply and cause an infection.

Urosepsis can occur if a UTI is left untreated. People who are more susceptible to urosepsis include:

When To See A Doctor

Urosepsis usually happens when youâve been hospitalized or have been recently hospitalized. However, you can get urosepsis if you have a UTI, regardless of whether or not youâve been to a hospital.

If your UTI hasnât been responding to treatment, talk to your doctor. Certain symptoms such as rapid breathing and confusion require immediate care.

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Other Symptoms Of Utis

If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI.

These pages explain what a UTI is, the different types of UTIs, their symptoms and treatments, and gives tips on how they may be prevented.

How Do You Get A Uti

The design of the human body makes it so it isnt difficult to get a bacterial UTI, because the infection comes from outside, through the urethra. Bacteria in the genital area near the opening of the urethra find their way in to the urinary tract, either because wiping after going to the bathroom, sexual activity, or unsanitary conditions. Once the bacteria has entered the urethra, the body tries its best to fight it off, but sometimes the immune system cant do this, the bacteria multiply, and cause the infection.

In the case of a fungal infection, usually the fungus gets to the urinary tract through the blood stream. Those who develop this type of infection are usually ill with a disease that has compromised their immune system, such as AIDS.

In general, women get more UTIs than do men and this increases with age. Statistics show that many women get more than one. Almost 20% of women who have had one UTI will go on to have a second. Of this 20%, 30% of those will have a third, and in turn, 80% of these women will have more.

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What Are The Symptoms Of Urosepsis

Urosepsis shares many of the same symptoms as other types of sepsis, including rapid heart rate, rapid breathing, weak pulse, profuse sweating, unusual anxiety, changes in mental status or level of consciousness, and decreased or absent urinary output. Prior to the development of these symptoms, you may experience symptoms of a urinary tract infection.