Sepsis

Definition
local or generalized invasion of the body b
y pathogenic microorganisms or their toxi
ns: dental sepsis; woundsepsis.
Dictionary.com
Continue even after the infection that
caused it is gone
Severe Infection
Whole body inflammation
Organ Dysfunction


Cause
Response to a serious infection
bacteria, fungi, viruses, and parasites
Primary Infection
Most common: Lung, Abdomen, UTI
Bood, Skin and other tissues
Secondary Infection
multiple organ dysfunction syndrome
Signs and Symptoms
Symptoms
Fever or hypothermia, rapid breathing, elevated
heart rate, confusion, and edema

Early Signs
elevated heart rate, decreased urination,
and elevated blood sugar

Established signs
confusion, metabolic acidosis + respiratory
alkalosis (faster breathing), low blood pressure,
decreased systemic vascular resistance,
higher cardiac output, and dysfunctions of blood
coagulation.

Pathophysiology
Caused by a combination of factors
1. Microbial factors
Virulence factors
Capsule prevents phagocytosis
Bacterial Pili: Adhesion to kidneys ept.
Endotoxin: LPS in G-
Exotoxin: Botulinum toxin in G+


Pathophysiology
2. Host Factor
Multiple organ dysfunction syndrome
Pulmonary dysfunction eg. Coagulation
Oliguria (decreased urine production)
Low blood pressure (Hypotension)
Low blood flow to organs
FROM DIFFUSE INTRAVASCULAR COAGULATION!!
Exotoxin induced cytokine production
TNF, IL1, IL6 > Procoagulation factors> Microvascular
Thrombosis
Systemic inflammatory response syndrome (SIRS)
Bacteremia





Exotoxin induced microvascular
coagulation


20-35% die
30-70% die
Management/Treatment
Antibiotics
For 7-10 days on basis of lab culture
Intravenous fluids
Heart rate, Blood pressure, Urine output
Ventilation
Tracheal intubation
Steroids
Adrenal insuffiency
Hemodialysis in kidney failure
Adequate nutrition
Parenteral Fluids