Complex Diagnosis: Sepsis with Anatomic Urinary Obstruction

A 40-year-old female presented with nonspecific symptoms but deteriorated rapidly, showing signs of sepsis with organ dysfunction. Despite a clear physical exam, lab results indicated severe illness, prompting antibiotic and fluid administration. Differential diagnoses considered included infectious diseases like endocarditis and necrotizing fasciitis, alongside shock subtypes like septic, cardiogenic, or metabolic. Ultimately, an obstructive urological cause was identified—a ureteral stone causing sepsis-specific shock—requiring urgent intervention and close collaboration with specialists for successful management.