Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Treatment of severe sepsis and septic shock associated with urogenital tract infection

요로감염과 관련된 중증 패혈증 및 패혈성 쇼크의 치료

  • Hwang, Kyu Bin (Graduate School of Medicine, Jeju National University) ;
  • Huh, Jung-Sik (Department of Urology, Jeju National University, Graduate School of Medicine) ;
  • Kim, Young-Joo (Department of Urology, Jeju National University, Graduate School of Medicine) ;
  • Park, Kyung Kgi (Department of Urology, Jeju National University, Graduate School of Medicine) ;
  • Kim, Sung Dae (Department of Urology, Jeju National University, Graduate School of Medicine) ;
  • You, Hyun Wook (Happey Urology Clinic)
  • 황규빈 (제주대학교 의학전문대학원) ;
  • 허정식 (제주대학교 의학전문대학원 비뇨기과학교실) ;
  • 김영주 (제주대학교 의학전문대학원 비뇨기과학교실) ;
  • 박경기 (제주대학교 의학전문대학원 비뇨기과학교실) ;
  • 김성대 (제주대학교 의학전문대학원 비뇨기과학교실) ;
  • 유현욱 (유쾌한비뇨의학과의원)
  • Received : 2020.11.09
  • Accepted : 2020.11.24
  • Published : 2020.12.31
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Abstract

Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.

Keywords

References

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