[Urosepsis. Update on diagnosis and treatment]. / Urosepsis. Aktuelles zu Diagnostik und Therapie.

BACKGROUND: Sepsis is an acute systemic response to the presence of bacteria and bacterial components in the macroorganism, and urosepsis is defined as sepsis caused by an infection in the urogenital tract. The urogenital tract is considered to be responsible for about 30 % of the cases of septic processes, whereby obstructive uropathy is causative in about 80 % of these cases. Sepsis manifests as an initially predominant proinflammatory response by widespread release of inflammatory mediators as a result of activation of cells responsive to infectious components such as bacterial toxins, which is then accompanied by a counter-regulatory anti-inflammatory response. DIAGNOSIS AND THERAPY: Prior to antibiotic therapy, blood and urine cultures are recommended, while procalcitonin and lactate can be considered diagnostically relevant biomarkers. Furthermore, early imaging to localize the level of obstruction and infectious focus should be carried out. Treatment is divided into causal therapy (antimicrobial therapy and infectious source), supportive therapy (fluids and oxygen administration), and adjunctive therapy (sepsis-specific therapy).