Septic shock following percutaneous nephrolithotomy: a case report and review of literature

Objective To explore the prevention and treatment of septic shock following percutaneous nephrolithotomy (PCNL). Methods A 62-year-old woman was found with calculi in both kidneys and hydronephrosis in the left kidney. Furthermore, bacterial culture from urine samplings revealed E. coli. Then she accepted anti-biotics therapy with ceftazidime (4g per day). Three days after initiation of anti-biotics therapy, percutaneous nephrolithotomy was performed, and nephrostomy was left after the procedure. Results Twelve hours after surgery the patient developed the symptoms of septic shock with blood pressure decreased, Heart rate increased and consciousness impaired, which was confirmed by the leucopenia and thrombocytopenia. After fluid replacement and antibiotic treatment were instituted, hemodynamic stabilization was obtained, and the patient's condition was markedly improved. Conclusion The monitoring of vital sign is of great clinical value for the patients after percutaneous nephrolithotomy. Anti-microbial therapy is important for the patients with urinary tract infection to prevent from septic shock after the surgery.