Snapshot A 44-year-old woman is brought to the emergency department by her husband for 2 days of generalize malaise, fatigue, and altered mental status. Her husband reports that she has been having a fever for the past 5 days with pain on urination and foul smelling urine. Medical history is significant for renal transplantation 4 years ago and is on tacrolimus and amlodipine. Her temperature is 101°F (38.3°C), blood pressure is 98/65 mmHg, pulse is 112/min, and respirations are 27/min. On physical exam, she is oriented to self but not place or time. Cardiopulmonary exam is unremarkable. Abdominal exam is notable for suprapubic tenderness upon palpation. She has costovertebral angle tenderness. She is immediately started on intravenous fluids and antibiotics and blood and urine studies are obtained. She is being transferred to the medical intensive care unit. (Urosepsis) Introduction Definition login to view 2 more bullets Systemic inflammatory response syndrome (SIRS) criteria login to view 6 more bullets Quick Sequential Organ Failure Assessment (qSOFA) score login to view 5 more bullets Epidemiology Most common bacteria include login to view 4 more bullets Risk factors login to view 8 more bullets Etiology Pathogenesis login to view 7 more bullets Gram-positive and -negative organisms are responsible for most cases E. coli and Group B Streptococcus are implicated in neonatal sepsis Presentation Symptoms login to view 15 more bullets Physical exam login to view 4 more bullets Studies Laboratory findings are nonspecific and can include login to view 8 more bullets Treatment Management approach login to view 4 more bullets Conservative login to view 6 more bullets Medical login to view 19 more bullets Complications Septic shock Disseminated intravascular coagulation Acute respiratory distress syndrome Acute renal failure Cardiomyopathy Prognosis Increased mortality in patients who are not treated