Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- 1 Fever of unknown origin (FUO)
- 2 Sepsis, severe sepsis, and septic shock
- 3 Chronic fatigue syndrome
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
2 - Sepsis, severe sepsis, and septic shock
from Part I - Clinical syndromes: general
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- 1 Fever of unknown origin (FUO)
- 2 Sepsis, severe sepsis, and septic shock
- 3 Chronic fatigue syndrome
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
DEFINITIONS
Sepsis is a complex syndrome that results from a host's response to infection. Simply put, it is the systemic inflammatory response syndrome (SIRS) arising because of documented or suspected infection. Clinically, SIRS is identified by the presence of at least two of the following: fever or hypothermia, tachycardia, tachypnea, and leukocytosis or leukopenia. Severe sepsis is sepsis with organ dysfunction or tissue hypoperfusion from the infection. Septic shock is severe sepsis plus hypotension that is not corrected by fluid resuscitation. Since 1991, the definitions and diagnostic criteria have expanded with inflammatory, hemodynamic, organ dysfunction, and tissue perfusion variables, but general definitions are the same. Sepsis-related terminology and definitions are in Table 2.1. Diagnostic criteria for sepsis are in Table 2.2. The document by a consensus committee of international experts called “Surviving Sepsis Campaign” has become one of the most comprehensive guidelines for clinicians as to best practice (though not yet standard of care) in the care of patients with severe sepsis and septic shock.
EPIDEMIOLOGY
The incidence of sepsis, severe sepsis, and septic shock are probably underestimated since most estimates are based on hospital databases that rely on the International Classification of Diseases, and so are biased toward a more severely ill population. The global incidence of sepsis is reported as from 22 to 240 cases/100 000 persons; severe sepsis from 13 to 300 cases/100 000 persons; and for septic shock, 11 cases/100 000 persons (based on a 2012 study). Case-fatality rates are as high as 30% for sepsis, 50% for severe sepsis, and 80% for septic shock. In the United States, the incidence of severe sepsis had been rising but in-hospital mortality was decreasing and not significantly different from Europe.
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- Chapter
- Information
- Clinical Infectious Disease , pp. 13 - 23Publisher: Cambridge University PressPrint publication year: 2015