CHEARS

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 .