title: [Analysis of patients with septic shock due to urosepsis brought on by ureteral calculi].
abstract: While a ureteral stone is a common disease, it occasionally causes urosepsis and septic shock. We analyzed 6 cases of septic shock due to urosepsis caused by a ureteral stone from August 1998 to September 2001. All patients were female, ranging in age from 38-76 years old (63.8 +/- 15.3). Stones ranged from 4 to 12 ml in size. The results of analysis of bacterial culture from blood and urine revealed E. coli in 4 cases, K. pneumoniae in 1 case and P. mirabilis in 1 case. Treatment, including intravenous transfusion, the administration of vasopressor drugs and antibiotics, and anti-disseminated intravascular coagulation (DIC) treatments were performed. Percutaneous nephrostomy in 4 cases and ureteral stent indwelling in 1 case were also used for the management of urinary tract. Extracorporeal shock wave lithotripsy (ESWL) was performed in 4 patients after improvement of general condition. Furthermore, the 3 most recent patients had also received therapy to remove endotoxins. All patients were diagnosed in a stone-free condition after a combination of these therapies. The mean recovery interval from shock condition to shock-free status seemed to be shorter in the patients that received the endotoxin removal therapy.
authors.affiliation: Department of Urology, Nagano Red Cross Hospital.
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Amano
authors.forename: Futoshi
authors.initials: F
authors.lastname: Matsui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takashima
authors.forename: Katsuro
authors.initials: K
authors.lastname: Takemae
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D018805:Sepsis / Q000209:etiology* / Q000628:therapy; D012772:Shock, Septic / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000150:complications* / Q000628:therapy; D014552:Urinary Tract Infections / Q000209:etiology* / Q000628:therapy