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Metastatic infection secondary to genitourinary tract sepsis
Abstract:
Metastatic infections arising from sepsis in the genitourinary tract are reviewed in 175 cases, including five in which we treated the patients. The skeleton was the most common site of metastasis (59 per cent). The endocardium was next most frequently involved (28 per cent). Gram-negative organisms were implicated in less than two-thirds of the cases (59 per cent). Impaired host defense mechanisms were noted in 25 per cent of the patients experiencing metastatic infections. The lower urinary tract was the source of metastasis in 75 per cent of the patients, particularly after urologic manipulation in men. Women were more likely to experience metastatic infection from the upper urinary tract. Anatomic and pathologic considerations explaining these sex differences are presented.
Insights
Metastatic infections from genitourinary sepsis most commonly spread to the skeleton and endocardium. Gram-negative bacteria were frequent culprits, especially in patients with impaired host defenses.
Area of Science:
- Infectious Diseases
- Urology
- Pathology
Background:
- Sepsis originating in the genitourinary (GU) tract can lead to metastatic infections.
- Understanding the patterns and origins of these metastatic infections is crucial for effective treatment.
Observation:
- A review of 175 cases of genitourinary sepsis with metastatic infections was conducted.
- The skeleton (59%) and endocardium (28%) were the most frequent sites of metastasis.
- Gram-negative organisms were involved in 59% of cases, and impaired host defenses were noted in 25%.
Findings:
- The lower urinary tract was the primary source of metastasis in 75% of patients, particularly after urologic manipulation in men.
- Women were more prone to metastatic infections originating from the upper urinary tract.
- Anatomical and pathological factors contribute to observed sex differences in metastatic patterns.
Implications:
- These findings highlight the importance of considering GU tract infections as a source of sepsis with distant spread.
- Recognizing sex-specific patterns can aid in earlier diagnosis and targeted interventions.
- Further research into host defense mechanisms and anatomical factors may improve patient outcomes.