Urosepsis: A simple infection turns toxic

    loading  Checking for direct PDF access through Ovid


Mr. H, 70, presented to the ED with complaints of low back pain, painful urination, fever, and chills that began earlier in the day. He underwent a lithotripsy 1 week earlier and had a medical history significant for diabetes mellitus and liver transplant 5 years earlier. On initial presentation, Mr. H was awake, alert, and ambulatory; his vital signs were: temperature, 102° F (38.9° C); heart rate, 120 beats/minute; respiratory rate, 22 breaths/minute; and BP, 110/70 mm Hg.
Forty-five minutes later, Mr. H's vitals were: temperature, 103.2° F (39.6° C); heart rate, 132 beats/minute; respiratory rate, 28 breaths/minute; and BP, 80/50 mm Hg. His physical exam was significant for lethargy, dry mucous membranes, costovertebral angle tenderness, and mottling bilaterally up to his knees. His lab tests included a white blood cell count of 1,000/mm3 and lactic acid of 4.3 mmol/L. Mr. H was diagnosed with urosepsis and needed prompt interventions to avoid further hemodynamic compromise.
    loading  Loading Related Articles