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An elderly man with a history of enlarged prostate experienced a sudden decline, presenting with confusion and shock. Prompt treatment for presumed urinary septic shock, including antibiotics and vasopressors, was initiated.

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Area of Science:

  • Urology
  • Critical Care Medicine
  • Infectious Disease

Background:

  • Enlarged prostate (benign prostatic hyperplasia) is common in older men.
  • Benign prostatic hyperplasia can necessitate intermittent straight catheterization.
  • Urinary tract infections can rapidly progress to sepsis.

Observation:

  • An 80-year-old male was found unresponsive after self-catheterization for benign prostatic hyperplasia.
  • Patient presented with altered mental status, fever, hypotension, and rapid atrial fibrillation.
  • Imaging revealed no acute intracranial or intra-abdominal pathology.

Findings:

  • The patient was diagnosed with presumed urinary septic shock.
  • Treatment included broad-spectrum antibiotics and norepinephrine for hemodynamic support.
  • Admission to the medical critical care unit was required for ongoing management.

Implications:

  • This case highlights the risk of severe sepsis in elderly men undergoing urinary catheterization.
  • Early recognition and aggressive management of septic shock are crucial for patient outcomes.
  • Maintaining vigilance for urinary tract infections in patients with benign prostatic hyperplasia is essential.