Fatal Urosepsis: A 41 Year-Old Pregnant Woman—Case Report

Abstract

Introduction: Urinary tract infections are one of the most frequent infectious complications during pregnancy [1], while acute pyelonephritis is the main non-obstetric reason for hospitalisation [2] [3] and septic shock in pregnant women. Objectives and methods: The aim of our study is to analyse the diagnostics and treatment of a 41-year-old pregnant woman with the most severe form of urinary tract infection—urosepsis. Case report: A 41-year old woman in the 12th week of pregnancy hospitalised at Intensive Care Unit (ICU) after urological intervention (JJ stent). On the first day after the intervention, the patient was diagnosed as having urosepsis. Scores: SOFA 14 pts, APACHE II 26 pts, SAPS II SCORE 61 pts. Second day in ICU: spontaneous abortion. Microbiological investigation: Escherichia coli—extended-spectrum beta-lactamase (ESBL+). Conclusions: A pregnant patient with a complicated infection of the urinary system ought to be treated in a multi-pro- file hospital, offering a possibility to consult doctors of various specialisations (urologist, gynaecologist, anaesthesiologist, nephrologist) as well as full access to a radiology laboratory, which will ensure the choice of appropriate and safe treatment for both the mother and the developing foetus.