Treatment of urosepsis induced by extracorporeal shock wave lithotripsy: analysis of 4 cases / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL).</p><p><b>METHODS</b>The clinical data were analyzed in 4 cases of urosepsis caused by ESWL during the period from January, 2008 to October 2011.</p><p><b>RESULTS</b>Two of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture revealed the presence of E. coli in 2 cases, Klebsiella pneumoniae in 1 case and Pseudomonas putida combined E. coli in 1 case. All the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and anti-inflammatory therapy. The vital signs of the patients became stable after 5-11 days (mean 6.75 days). Three patients underwent ureteroscopic lithotripsy, and 1 patient had emergency ureteral stent indwelling. All the 4 patients were cured and discharged.</p><p><b>CONCLUSION</b>ESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for which early nonsurgical interventions should be administered immediately after the diagnosis is established.</p>