---
title: "Septic Shock After Cystostomy in an Elderly Catheter-Dependent Patient: Fatal Case from Delayed In"
id: "pubmed-42555538"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42555538"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42555538/"
doi: "10.12659/AJCR.952428"
published_at: "2026-08-05T00:00:00.000Z"
evidence_level: "Case Reports"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Septic Shock After Cystostomy in an Elderly Catheter-Dependent Patient: Fatal Case from Delayed In
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42555538
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42555538/)
- **DOI:** [10.12659/AJCR.952428](https://doi.org/10.12659%2FAJCR.952428)
- **Published At:** 2026-08-05T00:00:00.000Z
- **Evidence Rating:** Case Reports
## Executive GIST (TL;DR)
- A 76-year-old man with hypertension, type 2 diabetes mellitus, and prior cerebral infarction was bedbound with impaired consciousness and long-term **indwelling urinary catheter** for urinary retention due to benign prostatic hyperplasia. - The patient's urethral catheter was accidentally dislodged; he presented to the emergency department 8 hours later at 20:30 on November 1, 2025. A **cystostomy** was recommended but he declined and left against medical advice. - He returned the next morning (around 08:00 on November 2, 2025) and consented to cystostomy; during the procedure he developed **septic shock**. - Postoperatively he required intensive care unit transfer. After three days the family opted to discontinue active treatment and took the patient home; he died two days after discharge. - The case report emphasizes the danger of insidious infections in elderly, frail, catheter-dependent patients and underscores the need for early **infection screening**, prompt **sepsis recognition** before procedures, ensuring catheter patency, and appropriate home care. - The report is indexed (PMID: 42555538) and published with DOI 10.12659/AJCR.952428; it highlights a fatal outcome associated with delayed diagnosis of infection in the context of cystostomy.
## Clinical Analysis & Structured Key Points
Clipboard, Search History, and several other advanced features are temporarily unavailable. [ Skip to main page content ](https://pubmed.ncbi.nlm.nih.gov/42555538/#article-details) ![U.S. flag](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png) An official website of the United States government Here's how you know ![Dot gov](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg) **The .gov means it’s official.** Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. ![Https](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg) **The site is secure.** The **https://** ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. [ ![NIH NLM Logo](https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg) ](https://www.ncbi.nlm.nih.gov/) [Log in](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42555538%2F) Show account info Close #### Account Logged in as: **username** * [Dashboard](https://www.ncbi.nlm.nih.gov/myncbi/) * [Publications](https://www.ncbi.nlm.nih.gov/myncbi/collections/bibliography/) * [Account settings](https://www.ncbi.nlm.nih.gov/account/settings/) * [Log out](https://www.ncbi.nlm.nih.gov/account/signout/?back_url=https%3A//pubmed.ncbi.nlm.nih.gov/42555538/) [Access keys](https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys) [NCBI Homepage](https://www.ncbi.nlm.nih.gov) [MyNCBI Homepage](https://pubmed.ncbi.nlm.nih.gov/myncbi/) [Main Content](https://pubmed.ncbi.nlm.nih.gov/42555538/#maincontent) [Main Navigation](https://pubmed.ncbi.nlm.nih.gov/42555538/) [ ![pubmed logo](https://cdn.ncbi.nlm.nih.gov/pubmed/af7de7da-df5d-41c6-8de4-8c266af8ccfb/core/images/pubmed-logo-blue.svg) ](https://pubmed.ncbi.nlm.nih.gov/) [ ](https://pubmed.ncbi.nlm.nih.gov/42555538/ "Show search bar") Search: [](https://pubmed.ncbi.nlm.nih.gov/42555538/ "Clear search input")Search [Advanced](https://pubmed.ncbi.nlm.nih.gov/advanced/) [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/clipboard/) [ User Guide ](https://pubmed.ncbi.nlm.nih.gov/help/) Save Email Send to * [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42555538%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42555538%2F%23open-collections-panel) * [Citation manager](https://pubmed.ncbi.nlm.nih.gov/42555538/) Display options Display options Format Abstract PubMed PMID ## Save citation to file Format: Summary (text) PubMed PMID Abstract (text) CSV Create file Cancel ## Email citation Email address has not been verified. Go to [ My NCBI account settings ](https://account.ncbi.nlm.nih.gov/settings/) to confirm your email and then refresh this page. To: Subject: Body: Format: Summary Summary (text) Abstract Abstract (text) MeSH and other data Send email Cancel ### Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42555538/) Add Cancel ### Add to My Bibliography * My Bibliography Unable to load your delegates due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42555538/) Add Cancel ## Your saved search Name of saved search: Search terms: [Test search terms](https://pubmed.ncbi.nlm.nih.gov/42555538/) Would you like email updates of new search results? Saved Search Alert Radio Buttons * Yes * No Email: ([change](https://www.ncbi.nlm.nih.gov/account/settings/)) Frequency: Monthly Weekly Daily Which day? The first Sunday The first Monday The first Tuesday The first Wednesday The first Thursday The first Friday The first Saturday The first day The first weekday Which day? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Report format: Summary Summary (text) Abstract Abstract (text) PubMed Send at most: 1 item 5 items 10 items 20 items 50 items 100 items 200 items Send even when there aren't any new results Optional text in email: Save Cancel ## Create a file for external citation management software Create file Cancel ## Your RSS Feed Name of RSS Feed: Number of items displayed: 5 10 15 20 50 100 Create RSS Cancel RSS Link Copy ### Actions Cite Collections Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42555538/) Add Cancel Permalink Permalink Copy Display options Display options Format Abstract PubMed PMID ### Page navigation * [ Title & authors ](https://pubmed.ncbi.nlm.nih.gov/42555538/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42555538/#abstract) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42555538/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42555538/#mesh-terms) Title & authors Abstract Publication types MeSH terms Case Reports Am J Case Rep Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Am+J+Case+Rep%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Am+J+Case+Rep%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) . 2026 Aug 5:27:e952428. doi: 10.12659/AJCR.952428. # Septic Shock Associated With Cystostomy: A Fatal Case Due to Delayed Infection Recognition [Qiang Ren](https://pubmed.ncbi.nlm.nih.gov/?term=Ren+Q&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#full-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China."), [Junbiao Zheng](https://pubmed.ncbi.nlm.nih.gov/?term=Zheng+J&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#full-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China."), [Jianeng Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+J&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#full-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China."), [Hankai Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+H&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#full-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China.") Affiliations Expand ### Affiliation * 1 Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China. * PMID: **42555538** * DOI: [ 10.12659/AJCR.952428 ](https://doi.org/10.12659/ajcr.952428) Item in Clipboard Case Reports # Septic Shock Associated With Cystostomy: A Fatal Case Due to Delayed Infection Recognition Qiang Ren et al. Am J Case Rep. 2026. Show details Display options Display options Format Abstract PubMed PMID Am J Case Rep Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Am+J+Case+Rep%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Am+J+Case+Rep%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) . 2026 Aug 5:27:e952428. doi: 10.12659/AJCR.952428. ### Authors [Qiang Ren](https://pubmed.ncbi.nlm.nih.gov/?term=Ren+Q&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#short-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China."), [Junbiao Zheng](https://pubmed.ncbi.nlm.nih.gov/?term=Zheng+J&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#short-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China."), [Jianeng Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+J&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#short-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China."), [Hankai Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+H&cauthor_id=42555538)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555538/#short-view-affiliation-1 "Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China.") ### Affiliation * 1 Department of Urology Surgery, The First People's Hospital of Jiashan, Jiashan, Zhejiang, China. * PMID: **42555538** * DOI: [ 10.12659/AJCR.952428 ](https://doi.org/10.12659/ajcr.952428) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract BACKGROUND Septic shock is highly prevalent in clinical practice. Some cases present insidiously and have poor prognoses. We report a case of a patient with a dislodged catheter who developed septic shock during a cystostomy procedure. CASE REPORT Our patient was a 76-year-old man with a history of hypertension, type 2 diabetes mellitus, and cerebral infarction. He had been confined to bed for a long time following a cerebral infarction and had impaired consciousness. One year prior, he developed urinary retention due to benign prostatic hyperplasia. As he did not undergo surgical treatment, a long-term indwelling urinary catheter was subsequently placed. He initially presented to the emergency department of our hospital at 8: 30 PM on November 1, 2025, 8 hours after accidental urethral catheter dislodgement. A cystostomy was recommended, but he refused and left against medical advice. At approximately 8: 00 AM on November 2, 2025, he returned to the hospital and consented to cystostomy. During the procedure, he developed septic shock. Postoperatively, he was transferred to the intensive care unit for further treatment. Three days later, the family decided to discontinue active treatment and took the patient home. Follow-up revealed that the patient died 2 days after discharge. CONCLUSIONS This case highlights the critical importance of early infection screening and prompt sepsis recognition prior to surgical procedures in elderly, frail, and catheter-dependent patients. It also highlights the importance of keeping the catheter unobstructed and ensuring proper home care. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Publication types * Case Reports Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Case+Reports%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Case+Reports) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) ## MeSH terms * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Cystostomy* / adverse effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cystostomy%2Fadverse+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cystostomy) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Delayed Diagnosis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Delayed+Diagnosis%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Delayed+Diagnosis) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Fatal Outcome Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Fatal+Outcome%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Fatal+Outcome) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Shock, Septic* / diagnosis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Shock%2C+Septic%2Fdiagnosis%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Shock%2C+Septic) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) * Shock, Septic* / etiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Shock%2C+Septic%2Fetiology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Shock%2C+Septic) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555538/) [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42555538/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42555538%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42555538/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42555538%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42555538%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42555538/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited. Follow NCBI [ Twitter ](https://twitter.com/ncbi) [ Facebook ](https://www.facebook.com/ncbi.nlm) [ LinkedIn ](https://www.linkedin.com/company/ncbinlm) [ GitHub ](https://github.com/ncbi) [ ](https://ncbiinsights.ncbi.nlm.nih.gov/) [Connect with NLM](https://www.nlm.nih.gov/socialmedia/index.html) * [ Twitter ](https://twitter.com/NLM_NIH) * [ SM-Facebook ](https://www.facebook.com/nationallibraryofmedicine) * [ SM-Youtube ](https://www.youtube.com/user/NLMNIH) National Library of Medicine [8600 Rockville Pike Bethesda, MD 20894](https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323) [Web Policies](https://www.nlm.nih.gov/web_policies.html) [FOIA](https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office) [HHS Vulnerability Disclosure](https://www.hhs.gov/vulnerability-disclosure-policy/index.html) [Help](https://support.nlm.nih.gov/?pagename=pubmed%3Apubmed%3Aabstract%3ANONE) [Accessibility](https://www.nlm.nih.gov/accessibility.html) [Careers](https://www.nlm.nih.gov/careers/careers.html) * [NLM](https://www.nlm.nih.gov/) * [NIH](https://www.nih.gov/) * [HHS](https://www.hhs.gov/) * [USA.gov](https://www.usa.gov/)
## Related Clinical Research

- [Predicting In-Hospital Mortality at 72 Hours in ICU Patients with Sepsis and Hypertension](https://medichelpline.com/clinical-feed/medrxiv-0-prediction-of-in-hospital-mortality-at-a-72-hour-intensive-care-landmark-in.md)
- [Antenatal Interventions to Improve Newborn Survival: LiST Model Updates](https://medichelpline.com/clinical-feed/pubmed-42825345.md) (DOI: 10.7189/jogh.16.04303)
- [Diabetes and ASCVD Alter the Link Between sTNFR1 Levels and Sepsis Mortality](https://medichelpline.com/clinical-feed/pubmed-42813914.md) (DOI: 10.1097/CCM.0000000000007374)
- [Controlling Hypertension Could Avert Over 500,000 Deaths Annually, Analysis Finds](https://medichelpline.com/clinical-feed/medical-news-today-1-over-500-000-deaths-a-year-could-be-prevented-by-managing-blood-pressure.md)
- [Self-Management Program Lowers HbA1c, eGFR, SBP, LDL-C in High-Risk DKD Patients with Type 2 Diabe](https://medichelpline.com/clinical-feed/plos-one-11-effectiveness-of-a-self-management-intervention-on-clinical-outcomes-among.md)

## Navigation
- [← Back to Critical Care Feed](https://medichelpline.com/clinical-feed/critical-care.md)
- [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md)
## Medical & Regulatory Disclaimer

> [!CAUTION]
> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.