Urosepsis. Clinical picture, immunopathogenesis and therapy

Urosepsis still represents a life-threatening syndrome in urology. It is of ten developed in the course of an inflammatory process with obstructive uro pathy or after invasive, instrumental manipulation in the urogenital tract. Patients with a diminished immune response are particularly predisposed to develop urosepsis. The spectrum of germs comprises gram-negative bacteria such as E. coli, Klebsiella, or Pseudomonas. The first symptoms are fever, chills, tachycardia, and somnolence. In the further course septic shock wit h bacteremia, thrombocytopenia, circulatory breakdown, and failure of multi ple organs might occur. For therapy it is appropriate to give a broad-spect rum antibiotic, to stabilize the circulatory system, and to secure the urin e flow. Immunophathology is gaining significance as far as the understandin g of urosepsis is concerned, but it also offers supportive treatment option s, particularly when there is seven progress of disease and usual treatment s have not been successful.