Former President Bill Clinton is in the hospital with a rare and serious complication from a urinary tract infection (UTI). Clinton, 75, was admitted to the University of California Irvine Medical Center's intensive care unit for a urinary tract infection that spread to his bloodstream, causing sepsis, his doctors say.
"He was admitted to the ICU for close monitoring and administered IV antibiotics and fluids. He remains at the hospital for continuous monitoring," his doctors told CNN. They also said that Clinton was in the ICU for privacy and safety, but not because he needs intensive care.
Urinary tract infections are common, leading to 8 million to 10 million doctor's visits each year, according to the Cleveland Clinic. But most urinary tract infections don't lead to sepsis. How common is this and how can it happen? Doctors break it down.
What is a urinary tract infection, exactly?
A urinary tract infection is an infection of any part of your urinary system, which includes your kidneys, ureters, bladder, and urethra, according to the Mayo Clinic. Most UTIs involve the lower urinary tract, i.e. your bladder and urethra.
David Kaufman, MD, director of Central Park Urology, a division of Maiden Lane Medical, tells Health that while UTIs are much less common in men than women, they typically happen if a man has prostate enlargement, which can keep him from fully emptying his bladder.
"That can lead to a UTI because the urine in the bladder is sitting there like a cesspool," Dr. Kaufman explains. When men develop a UTI, "it's always considered a more complicated infection because it's just more difficult for men to get UTIs," he says.
Symptoms of a UTI can vary, but they usually include the following, per the Mayo Clinic:
- A strong, persistent urge to pee
- A burning sensation when you pee
- Passing frequent, small amounts of urine
- Urine that appears cloudy
- Urine that appears red, bright pink, or cola-colored
- Strong-smelling pee
- Pelvic pain, in women, especially in the center of the pelvis and around the area of the pubic bone.
What is sepsis?
Sepsis is the body's extreme response to an infection, and it's a life-threatening medical emergency, according to the Centers for Disease Control and Prevention (CDC). Sepsis happens when an infection you already have triggers a chain reaction in your body, causing symptoms like a high heart rate or low blood pressure, fever, shivering, or feeling cold, confusion or disorientation, shortness of breath, extreme pain or discomfort, and clammy or sweaty skin.
Sepsis can be deadly: Nearly 270,000 Americans die of the condition each year, the CDC says.
How can a urinary tract infection lead to sepsis?
It's important to point out that sepsis is not a common complication of a UTI. "It's rare but it's serious," Blaine Kristo, MD, medical director of The Urology Specialists of Maryland, tells Health. "It is more common as people age, but it's still not common overall."
Lewis Nelson, MD, chair of emergency medicine at Rutgers New Jersey Medical School, agrees. "UTIs are generally easy to treat with antibiotics, so most people with UTIs do not progress to systemic signs of sepsis," he tells Health. "That said, antibiotics can fail for multiple reasons." In other words, a person can be on antibiotics for a UTI, but they may not be effective at stopping the infection for many potential reasons—including the possibility of an antibiotic-resistant infection.
It takes two days for a urinary culture to grow in a lab, Dr. Kristo points out, and it would take that long for doctors to know exactly what kind of bacteria was behind a patient's UTI and whether it's antibiotic resistant. "During that time, the infection can progress," he says.
If a patient has an obstruction in the kidney, ureter, or bladder, that can also make it difficult to fully empty out urine, which can cause a UTI to get worse, Dr. Kristo says, and potentially result in sepsis.
It's also possible to have a UTI and not realize it, Dr. Kristo adds, which can delay care and cause the infection to get worse.
How is sepsis from a UTI treated?
People who develop sepsis, whether from a UTI or other infection, can be admitted to the hospital for ongoing observation or treatment, Dr. Nelson says. There, they'll usually be given IV antibiotics for a period of time and monitored, Dr. Kristo says.
The news is scary, especially if you're prone to developing UTIs, but Dr. Nelson stresses that this is not something that happens often. "Life-threatening sepsis from a UTI in an otherwise healthy patient is very uncommon," he says.
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