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Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
Septic shock is also a strong predictor of short- and long-term mortality. Case-fatality rates are similar for culture-positive and culture-negative severe sepsis. The Mortality in Emergency Department Sepsis (MEDS) score is simpler and useful in the emergency department environment.
In septic shock the blood flow in the microvasculature is abnormal with some capillaries underperfused and others with normal to high blood flow. [5] The endothelial cells lining the blood vessels become less responsive to vasoconstrictive agents, lose their glycocalyx (normal coating) and negative ionic charge, become leaky and cause extensive ...
For every hour a patient is denied AB therapy after the onset of septic shock, the patient's chance of survival is reduced by 7.9% (Survivesepsis.org 2005). The 2012 guidelines differ: Administration of broad-spectrum antimicrobials therapy within 1 hr of recognition of septic shock (1B) and severe sepsis without septic shock. [7]
The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. [8] According to an observational study at an Intensive Care Unit (ICU) in Belgium, the mortality rate is at least 50% when the score is increased, regardless of initial score, in the first 96 hours of admission, 27% to 35% if the score remains unchanged, and less than 27% if the score is reduced. [9]
Septic shock, especially septic shock where treatment is delayed or the antimicrobial drugs are ineffective, however has a mortality rate between 30% and 80%; cardiogenic shock has a mortality rate of up to 70% to 90%, though quick treatment with vasopressors and inotropic drugs, cardiac surgery, and the use of assistive devices can lower the ...
Adrenal crisis; Other names: Acute adrenal insufficiency, Addisonian crisis, Acute adrenal failure. [1]49-year-old male with an adrenal crisis. Appearance, showing lack of facial hair, dehydration, Queen Anne's sign (panel A), pale skin, muscular and weight loss, and loss of body hair (panel B).
Septic abortion is diagnosed using clinical evaluation, bacterial cultures, and ultrasonography on people who present with signs and symptoms with intrauterine infections following by an abortion within 20 weeks of gestation. Medical history and physical examination are used as the first line in identifying people who are suspected of having a ...