Septic Shock Secondary to Klebsiella Pneumoniae Catheter-Related Bloodstream Infection in a Patient with Displaced Double J Stent: a Case Report

Abstract

Sepsis is a life-threatening condition caused by a dysregulated host immune response to infection leading to organ dysfunction. Septic shock is a severe form characterized by circulatory and metabolic abnormalities with high mortality. It is diagnosed when vasopressors are required to maintain a mean arterial pressure (MAP) ≥65 mmHg despite adequate fluid resuscitation. Sepsis commonly originates from respiratory, gastrointestinal, genitourinary, or skin infections. Early diagnosis and prompt management with fluids, antimicrobial therapy, and vasopressor support are essential to improve survival.

Case Presentation: A 54-year-old male was admitted to Ballari Medical College and Research Centre (BMCRC), Ballari, Karnataka, with complaints of giddiness and bilateral lower limb swelling with difficulty walking for three days. He had a history of bilateral ureteric calculi with double J (DJ) stent placement and had undergone three cycles of maintenance hemodialysis. On examination, the patient was hypotensive (80/60 mmHg) and tachycardic (102 beats/min). Laboratory investigations showed severe anemia, leukocytosis, elevated creatinine and urea, and high inflammatory markers including procalcitonin and C-reactive protein. Blood culture revealed Klebsiella pneumoniae. Ultrasonography showed bilateral pyelonephritis with cystitis and displacement of the right-sided DJ stent. The patient received intravenous fluids, vasopressors, antibiotics, and supportive care with clinical improvement.

Case Discussion: Urinary instrumentation and indwelling devices increase the risk of bloodstream infections. In this case, septic shock was associated with Klebsiella pneumoniae infection and displacement of the DJ stent. Early diagnosis and culture-guided antibiotic therapy were important for effective management.

Conclusion: Sepsis due to catheter-related bloodstream infection requires early recognition, prompt antibiotics, and effective source control. Multidisciplinary care and monitoring are essential to improve outcomes, especially in patients with chronic kidney disease and urinary devices.