Sepsis

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Definition

There are some issues with definition that need to be cleared up

  • SIRS (systemic inflammatory response syndrome) - body's defensive response to an acute, serious systemic illness. Outlined in further details below as sepsis is a major cause.
  • Sepsis - infection with SIRS
  • Bacteraemia - presence of bacteria in blood
  • Septicaemia - obsolete term (though still used instead of sepsis) which is an inaccurate combination of the above two.
  • Severe sepsis - sepsis with signs of end-organ failure (see below)
  • Septic shock - shock due to sepsis

Epidemiology

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Pathophysiology

Whenever you get an infection, it's not great. However, when it enters your bloodstream, things tend to get markedly worse.

Risk Factors

Having an infection.

Clinical Features

Sepsis is due to infection so general symptoms of infection apply: fever, tiredness

Then, you need to look at SIRS which is where 2 of the following are present:

  • Temperature >38oC/<36oC
  • Tachycardia (>90bpm)
  • Tachypnoea (RR>20b/min)/PaCO2<4.3kPa
  • WBC>12x109/L

Management

Basically see hypovolaemic shock and do what you would do for them. Then add the appropriate antibiotics:

Prognosis