15 September 2021
Bacteremia refers to the transient presence of organisms in the blood ( generally without causing symptoms) as a result of local infection or penetrating injury. septicemia is reserved for the clinical picture that results from the systemic inflammatory response to infection.
PATHOPHYSIOLOGY: polymorphonuclear leucocytes, macrophages, and lymphocytes, which release inflammatory mediators, including TNF, IL-1, platelet-activating factor, IL-6, IL-8, and interferon which leads to symptoms like fever, tachycardia, increased respiratory rate, and hypotension.
40% cases- caused by gram-positive bacteria
60% cases- caused by gram-negative bacteria
Fungi - less common
Infection in chest
Urinary tract infection
IV drug use
Fever , rigors and hypotension
minor change in conscious level.
Waterhouse-friedrischsen syndrome ( caused by niesseria meningitidis) which shows skin rash, shock, and adrenal hemorrhage
stapylococci- produce endotoxin called toxic shock syndrome ( causing fever, rash, diarrhoea and shock)
Antibiotic therapy is the most appropriate for the probable site of origin of sepsis in accordance with local antibiotic policies.
Therapy should subsequently be rationalized on the basis of culture and sensitivity results.
In severe sepsis and septic shock, attention should be paid to fluid resuscitation and often the patient will be best managed in critical care environment .