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

Richard H. Sinert, DO

Disclosures

June 07, 2018

If clinical suspicion of necrotizing fasciitis is high, a surgical consultation should be obtained immediately, and the patient should be taken promptly to the operating room for intervention, often without the need for any imaging. CT and MRI cannot be relied on to make this diagnosis.

Chest radiography detects infiltrates in about 5% of febrile adults without localizing signs of infection; accordingly, it should be routine in adults who are febrile without localizing symptoms or signs and in patients who are febrile with neutropenia and without pulmonary symptoms. Chest radiography is useful in detecting radiographic evidence of ARDS, which carries a high mortality. The discovery of such evidence on a chest x-ray should prompt consideration of early intubation and mechanical ventilation, even if the patient has not yet shown signs of overt respiratory distress.

In adult patients with suspected intra-abdominal infection who are not undergoing immediate laparotomy, CT scanning of the abdomen is preferable to abdominal radiography. CT is the imaging modality of choice for excluding an intra-abdominal abscess or a retroperitoneal source of infection. Obesity or the presence of excessive intestinal gas markedly interferes with abdominal imaging by ultrasonography; therefore, CT is preferred in this setting.

For more on imaging studies in patients with sepsis, read here.

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