Septic shock in urological practice: what is important for doctors to remember

Urological pathology in most cases is associated with the penetration of pathogenic microflora into the body and the development of an infectious-inflammatory process. With timely initiated and properly selected treatment, namely the appointment of an antibiotic therapy regimen, most inflammatory urological processes can be cured fairly quickly. But there are situations when the body attacks so many bacteria that even strong antibiotics cannot cope with them. At the same time, a severe and very dangerous condition develops in the patient's body – septic shock.

Clinical presentation of septic shock: warning symptoms

In the literature, you can find such names for septic shock as bacteremic, endotoxic, bacteriotoxic or toxicoinfectious shock. All these synonyms mean one thing: a dangerous condition develops in the patient's body, which in almost 90% of cases ends in death. Septic shock develops as a result of the penetration into the patient's body of a large number of predominantly gram-negative microorganisms that produce endotoxin. In urology, septic shock can occur after endoscopic operations or studies, instrumental manipulations on the organs of the urinary system, or as a result of purulent processes in the urinary organs.

Septic shock:

• main forms of septic shock in urology;
• clinical presentation of septic shock: characteristic symptoms;
• stages of septic shock in urologic patients.

Main forms of septic shock in urology

There are four main forms of septic shock in patients with urinary disorders:

• erased form: characterized by the onset of the disease on the first day, manifested by moderate chills, lowering blood pressure and fever;
• early form: occurs in the first few hours, while its early manifestations – is it fever or collapse;
• distant form: occurs somewhat later than the first two forms, after an intermediate stage. In this form, the focus of infection is often located in the kidneys, epididymis, or lungs of the patient;
• late form occurs in the final stage of sepsis.

Read also: Dysuria – alarm urinary system of the body

Clinical presentation of septic shock: characteristic symptoms

The clinical picture of septic shock in most cases is pronounced. The patient's body temperature rises to 39-41°C, chills occur, pallor of the skin, acrocyanosis, and cold sweat are observed. The pulse is frequent, up to 160 / minute, & nbsp; but very weak, arterial pressure decreases, arrhythmia, shallow breathing are characteristic. Diuresis is significantly reduced, up to the complete cessation of urine output, involuntary urination or defecation may occur. The patient's consciousness is disturbed: there is excitement or, conversely, depression, general weakness, loss of consciousness, clonic and tonic convulsions.

Stages of septic shock in urologic patients

There are three stages in the clinical course of septic shock in urological patients:

• early stage – observed on the first day after the intervention on the organs of the urinary system, which could presumably lead to the development of septic shock. It is characterized by a slight deterioration in the general condition of the patient, which is manifested by an increase in body temperature and a moderate decrease in blood pressure;
• advanced stage – occurs in the first hours or days after the intervention, is characterized by the development of collapse, an increase in body temperature and a sharp deterioration in the patient's condition;
• non-negotiable stage – this is a severe insufficiency of the circulatory organs and kidneys, which cannot be corrected with drugs.