Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Sepsis

Richard H. Sinert, DO

Disclosures

June 07, 2018

Risk factors for severe sepsis and septic shock include the following:

  • Extremes of age (<10 years and >70 years)

  • Primary diseases (eg, liver cirrhosis, alcoholism, diabetes, cardiopulmonary diseases, solid malignancy, and hematologic malignancy)

  • Immunosuppression (eg, from neutropenia, immunosuppressive therapy [eg, in organ and bone marrow transplant recipients], corticosteroid therapy, injection or intravenous drug use, complement deficiencies, asplenia)

  • Major surgery, trauma, or burns

  • Invasive procedures (eg, placement of catheters, intravascular devices, prosthetic devices, hemodialysis and peritoneal dialysis catheters, or endotracheal tubes)

  • Previous antibiotic treatment

  • Prolonged hospitalization

  • Underlying genetic susceptibility

  • Other factors (eg, childbirth, abortion, and malnutrition)

In the more common form of MODS, the lungs are the predominant, and often the only, organ system affected until very late in the disease. Patients with this form of MODS most often present with a primary pulmonary disorder (eg, pneumonia, aspiration, lung contusion, near-drowning, chronic obstructive pulmonary disease exacerbation, hemorrhage, or pulmonary embolism). In the second, less common, form of MODS, the presentation is quite different. Patients affected by this form often have an inciting source of sepsis in organs other than the lung; the most common sources are intra-abdominal sepsis, extensive blood loss, pancreatitis, and vascular catastrophes.

In most patients with sepsis, a source of infection can be identified. The exceptions are patients who are immunocompromised with neutropenia, in whom an obvious source often is not found. Respiratory tract and abdominal infections are the most frequent causes of sepsis, followed by urinary tract and soft tissue infections.

For more on the etiology and epidemiology of sepsis, read here.

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