Acute Sepsis Flashcards
Purpuric rash
Non-blanching
Sepsis definition
Life-threatening organ dysfunction due to a dysregulated host response to infection
Septic shock definition
Persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation
Bacteraemia
Presence of bacteria in the blood
EWS
Early warning score, basic observation, 3 or more should be considered as septic
Complete sepsis six bundle
Oxygen Blood cultures IV antibiotics Fluid challenge Lactate Measure urine output
Urgent investigations
Full blood count, Urea and Electrolytes EDTA bottle for PCR Blood sugar Liver Function Tests C-Reactive protein (CRP) Coagulation (clotting) studies Blood gases Other microbiology samples (CSF, urine, etc)
Endotoxin
Triggers inflammation
Lipopolysaccharide
Pilus
Enhances attachment
Polysaccharide
Promotes adherence
Prevents phagocytosis
Sepsis and coagulation
Cytokines initiate production thrombin
Cytokines inhibit fibrinolysis
Coagulation cascade leads to microvascular thrombosis and hence
Organ ischaemia
Microvascular injury is the major cause of shock and multiorgan failure
Antibiotic choice for meningitis
Ceftriaxone
Penetrates into the CSF
Life threatening complications of meningitis
Irreversible hypotension Respiratory failure Acute kidney injury (renal failure) Raised intracranial pressure Ischaemic necrosis of digits/hands/feet
Neisseria meningitidis: gram pos or neg, serogroups
Gram negative
Serogroups A, B, C, W135
Based on polysaccharide capsular antigen