Nishi Sheth
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Septicemia

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.

 

ETIOLOGY:

40% cases- caused by gram-positive bacteria

60% cases- caused by gram-negative bacteria

Fungi - less common

 

Risk factor:

  • Infection in chest

  • Urinary tract infection

  • IV drug use

  • Hospitalized patients

Clinical presentation:

  • Fever , rigors and hypotension

  • Lrthargy, headache

  • 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)

Diagnosis:

  • Blood count

  • Serum electrolytes

  • Liver biochemistry

  • Blood culture

  • chest radiograph

Managment:

  • 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 .

 

 

 

 

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