Sepsis complications

The cumulative burden of sepsis complications is the leading factor of mortality. The risk of death increases 20% with failure of each additional organ. Severe sepsis averages two failed organs, with a mortality rate of 40%. 

Determine the risk of sepsis complications and construct recommendations for treatment and monitoring. 

Robson S, Wilson K, Munday D et al. (1999) Pelvic sepsis complicating embolization of a uterine fibroid. Aust N Z J Obstet Gynaecol 39 516-517... 

Respiratory effects can lead to bacterial pneumonia and respiratory failure with death from secondary sepsis. Complications include chronic bronchitis and bronchial stenosis. Mustard gas is also thought... 

Spreading soft tissue infection and osteomyelitis are often the first complications that develop from diabetic foot infection. Some patients develop bacteremia and sepsis. 

Tens of thousands of Americans, including 1 of every 12 persons with spinal cord injury, die each year as a result of complications relating to pressure sores.41 Most complications are infectious. The most common is osteomyelitis, which is present in approximately 38% of infected pressure sores.37 Less frequently, NF, clostridial myonecrosis, and sepsis can occur. 

Severe disease is defined as the presence of complications of colitis, such as sepsis, volume depletion, electrolyte imbalance, hypotension, paralytic ileus, and toxic megacolon. Patients with signs of severe disease should receive oral vancomycin as initial therapy. Surgical intervention may be indicated and lifesaving, particularly in cases complicated by toxic megacolon or colonic perforation. 

Mustard RA, Bohnen JMA, Rosati C, Schouten D. Pneumonia com- Solomkin JS, Mazuski JE, Baron EJ, et al. Guidelines for the selection plicating abdominal sepsis. Arch Surg 1991 126 170-175. of anti-infective agents for complicated intraabdominal infec-... 

Assess complications of sepsis and discuss their impact on patient outcomes. 

Appropriate empiric anti-infective therapy decreases 28-day mortality. Appropriate therapy administered within 1 hour of the recognition of sepsis decreases complications and mortality. 

Laboratory tests to evaluate infection or complications of sepsis ... 

Appropriate empiric anti-infective therapy decreases 28-day mortality compared to inappropriate empiric therapy (24% versus 39%).22 23,30 Additionally, appropriate therapy administered within 1 hour of sepsis recognition also decreases complications and mortality.22-23,30 Empiric anti-infective therapy should include one, two, or three drugs, depending on the site of infection and causative pathogens (Table 79-3). Anti-infective clinical trials in sepsis and septic shock patients are scarce and have not demonstrated differences among agents therefore, factors that determine selection are ... 

Sepsis syndrome Anorexia nervosa Complications during pregnancy Geriatric patients with multiple chronic disease Organ transplantation Inborn errors of metabolism Cystic fibrosis Extreme prematurity... 

Septic shock is frequently complicated by massive activation of the coagulation system. This can occur concomitantly with biphasic change in the fibrinolytic system, involving both activation and inhibition of plasminogen activation. The net result of the altered hemostatic state in sepsis is widespread microvascular trom-bosis. The early events leading to these disturbances are incompletely understood,... 

Pathological findings frequently observed in organs of patients who have died of sepsis include disseminated intravascular coagulation (DIC), manifested as diffuse thrombotic occlusions in the entire microvascular system, associated with alterations in the hemostatic mechanism and clinical signs of hemorrhagic diathesis. Many observations indicate that DIC contributes to the major symptoms of the systemic inflammatory response syndrome (SIRS), which frequently complicate sepsis (HI, H2, H3, T6). 

Interaction with Other Cascade Systems. Interactions between the complement system, the kinin, and the coagulation and fibrinolytic systems have repeatedly been reported (S37, PI9). Activation of one system induces activation of the other systems. The reciprocal activation of the various cascade systems may have an important role in the pathogenesis of ARDS and MODS as complications of sepsis. Nevertheless, until now no convincing prophylactic or therapeutic effects of intervention in the complement cascade system on the severity of septic complications have been reported. 

Signs and Symptoms Abdominal pain, cramps, diarrhea, fever, vomiting, tenesmus, and blood, pus, or mucus in stools. Infections also cause mucosal ulceration, rectal bleeding, drastic dehydration. Serious less frequent complications include sepsis, seizures, convulsions, rectal prolapse, toxic megacolon, intestinal perforation, renal failure, and hemolytic uremic syndrome. 

Acute complications of SCD include fever and infection (e.g., sepsis caused by encapsulated pathogens such as Streptococcus pneumoniae), stroke, acute... 

Septic shock 1) shock associated with sepsis, usually associated with abdominal and pelvic infection complicating trauma or operations 2) shock associated with septicemia caused by Gram-negative bacteria. 

It is used for bacterial infections caused by microorganisms that are sensitive to the drug. These may be abdominal and gynecological infections, sepsis, meningitis, endocarditis, infections of the urinary and respiratory tracts, bones, joints, skin, and soft tissnes. It is widely nsed for pneumonia as well as bacterial meningitis in children, and for post-operational infections complications. Synonyms of this drug are ceftin, zinacef, curoxim, kefox, and many others. 

It is used for treating sepsis, meningitis, osteomyelitis, periotonitis, pneumonia, pyelonephritis, pyelocystitis, infected wounds, and post-operational purulent complications caused by microorganisms sensitive to the drug. Synonyms of this drug are karmycin, kamaxin, resistomycin, and many others. 

In an effort to overcome the lack of solubility, poor penetration across the blood-brain barrier and decreased delivery of conventional systemic agents by a compromised intratumoral blood supply, several studies have evaluated various combinations of BCNU alone or with other agents delivered intraarterally. Unfortunately, response rates and median survival times observed in patients treated with intraarterial chemotherapy have not been significantly different than those seen in patients treated with standard intravenous nitrosurea-containing regimens, while increased rates of toxicity such as leukoen-cephalopathy, retinal injury, edema, myelosuppression, sepsis, and thrombotic complications have been noted (40-46). 

L B. The patient has complicated urinary tract infection and nonsevere sepsis syndrome caused by P. aeruginosa. Effective antibiotics for Pseudomonas spp. include mezlocillin, piperacillin, piperacillin-tazobactam, ticarcillin, and ticarciUin-clavulanate. The carbapenems (imipenem and meropenem) and the monobactam (aztreonam) are also active against P. aeruginosa. Ampicillin-sulbactam and cefazolin are ineffective against P. 

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