What is Urosepsis

Urosepsis is an infection that has spread to the blood (sepsis) from the kidneys, ureters, bladder, and urethra (urinary tract). These organs make, store, and pass urine from the body. Urosepsis is a severe illness that can be life-threatening if it is not treated immediately.

What are the causes?

Causes of this condition include:

• A urinary tract infection (UTI) that spreads to your blood.
• A urinary tract blockage (obstruction) due to kidney stones.
• Having a small, thin tube in your urethra that drains urine from your bladder for a period of time (indwelling urinary catheter).
• Swelling of the prostate (prostatitis) or prostate infection (abscess), in men.

What increases the risk?

This condition is more likely to develop in people who:

• Are female.
• Are 65 or older.
• Have a long-term (chronic) disease, such as diabetes.
• Have a weak disease-fighting system (immune system).
• Have a condition that lessens or changes urine flow, such as a kidney or bladder stone, prostate disease, or a tumor of the urinary tract.
• Have had surgery of the urinary tract.
• Use a urinary catheter.
• Have lost feeling below the waist or are in a wheelchair.

What are the signs or symptoms?

Early symptoms of this condition are similar to symptoms of a severe UTI. These may include:

• Pain in your side, back, or lower abdomen.
• Fever and chills.
• Nausea and vomiting.
• Frequent need to pass urine.
• Burning pain when passing urine.
• Bloody or cloudy urine.
• Bad-smelling urine.
• Fatigue.

Once the infection has spread to the blood and a sepsis reaction starts, other symptoms may include:

• High fever.
• Chills with shaking.
• Fast breathing.
• Fast heartbeat.
• Cold and clammy skin.
• Anxiety.
• Confusion.
• Severe pain in the abdomen.
• Trouble breathing.
• Trouble passing urine or not being able to pass urine.
• Fainting.

How is this diagnosed?

This condition is diagnosed based on your symptoms, your medical history, and a physical exam. You may have urine tests or blood tests to check kidney function and look for infection. You may also have imaging tests to check for blockages in the urinary tract.

How is this treated?

This condition is a medical emergency that needs to be treated in the hospital. Treatment may include:

• Receiving one or more of the following through an IV:
  • Antibiotic medicines.
  • Fluids.
  • Medicines to support blood pressure.
• Oxygen and breathing support.
• Removing a urinary catheter that may be a source of infection, if you have one.
• Filtering your blood with a machine (dialysis).
• Surgery to drain infected areas or restore urine flow. This is rare.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine to take at home, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Drink enough fluid to keep your urine pale yellow.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

• Symptoms that get worse or do not get better with treatment.
• New UTI symptoms.

Get help right away if:

• You have new or continued symptoms of sepsis after hospitalization, such as:
  • High fever.
  • Chills.
  • Difficulty breathing.
  • Confusion.
  • Nausea and vomiting.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Urosepsis is an infection that has spread to the blood (sepsis) from the urinary tract. It is a severe illness that can be life-threatening if it is not treated immediately.
• Possible causes of urosepsis include a UTI that spreads to your blood, blockage from kidney stones, having a urinary catheter, or prostate swelling or infection.
• This condition is a medical emergency that is treated in the hospital with antibiotics.

Urosepsis, Newborn

Urosepsis is a severe illness that occurs when an infection starts in the urinary tract and spreads into the bloodstream. The urinary tract includes:

• The kidneys.
• The bladder.
• The ureter. This is the part of the body that drains urine from the kidneys to the bladder.
• The urethra. This is the part of the body that drains urine from the bladder out of the body.

Neonatal urosepsis is a type of urosepsis that develops in a baby who is younger than 30 days old. Newborns with urosepsis almost always need to stay in the hospital for treatment.

What are the causes?

This condition is caused by bacteria in your child’s urinary tract. The bacteria may come from:

• A different part of the body. The bacteria may travel through the blood to the urinary tract, grow in the kidneys or bladder, and then re-enter the bloodstream.
• Outside of the body. The bacteria may enter the body through the urethra, grow in the bladder, and then spread to the kidneys and into the blood.

What increases the risk?

The following factors may make your child more likely to develop this condition:

• Being born before 37 weeks of pregnancy (premature). Premature babies have a harder time fighting infection than full-term babies, so there is a greater chance that an infection will spread to their blood.
• Being male.
• Having an abnormal urinary tract. If urine cannot flow correctly, infection of the urinary tract is more likely to occur.

What are the signs or symptoms?

Symptoms of this condition include:

• Poor feeding.
• High fever.
• Urinating small amounts.
• Being very sleepy.
• Irritability.
• Strong-smelling urine.
• A skin rash.
• Pale or blue skin.
• Little movement. The baby may seem floppy.
• Trouble breathing.

How is this diagnosed?

This condition may be diagnosed based on:

• Your baby’s symptoms.
• A physical exam.
• Urine tests.
• Blood tests.
• Removal and examination of a small amount of the fluid that surrounds the brain and spinal cord (lumbar puncture).
• Ultrasound of the urinary tract.

If an ultrasound result shows an abnormality of the urinary tract, your baby may need to have a special type of X-ray called voiding cystourethrography. For this test, a dye is put into your baby’s bladder and an image is taken while he or she is passing urine.

How is this treated?

This condition is usually treated in the hospital with:

• Antibiotic medicine given through IV. Your baby may also get blood pressure medicine.
• IV fluids to prevent your baby from losing too much body fluid (dehydration) and to help keep your baby’s blood pressure steady.
• A machine to help your baby breathe (respirator).

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• If your child was prescribed an antibiotic medicine, give the antibiotic as told by your child’s health care provider. Do not stop giving the antibiotic even if your child starts to get better.

General instructions

• Check your baby often for signs of urinary tract infection. These include:
  • Fever.
  • Vomiting.
  • Poor feeding.
  • Irritability.
  • Strong-smelling urine.
• Make sure your baby is feeding well and wetting his or her diaper as expected.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your baby is not feeding well.
• Your baby seems irritable.
• Your baby’s diaper smells strongly of urine.
• Your baby is vomiting.

Get help right away if:

• Your baby who is younger than 3 months has a fever of 100.4°F (38°C) or higher.
• Your baby who is younger than 1 month has signs or symptoms of urinary tract infection.
• Your baby’s skin becomes pale or bluish.
• Your baby is hard to wake up.
• Your baby has trouble breathing.

Summary

• Neonatal urosepsis is a blood infection that is caused by bacteria in your baby’s urinary tract.
• Males, premature babies, and babies with abnormal urinary tracts are at an increased risk for urosepsis.
• Your baby may need medicines to support blood pressure and treat the infection, as well as IV fluids to prevent dehydration.
• Once your baby comes home from the hospital, it is important to give all medicines as told by your child’s healthcare provider and to watch for signs of urinary tract infection.