Differential Diagnosis

Infectious Causes of Sepsis: Abscesses, mycobacterial infections (tuberculosis), pyelonephritis, endocarditis, wound infection, diverticulitis, cholangitis, osteomyelitis, IV catheter phlebitis, pelvic infection, cellulitis, infected decubitus ulcer, peritonitis, abdominal abscess, perirectal abscess, parasitic infections.

Defining sepsis and related disorders

Term

Definition

Systemic inflammatory response syndrome (SIRS)

The systemic inflammatory response to a severe clinical insult manifested by $2 of the following conditions: Temperature >38°C or <36°C, heart rate >90 beats/min, respiratory rate >20 breaths/min or PaCÛ2 <32 mm Hg, white blood cell count >12,000 cells/mm3 , <4000 cells/mm3 , or >10% band cells

Sepsis

The presence of SIRS caused by an infectious process; sepsis is considered severe if hypotension or systemic manifestations of hypoperfusion (lactic acidosis, oliguria, change in mental status) is present.

Septic shock

Sepsis-induced hypotension despite adequate fluid resuscitation, along with the presence of perfusion abnormalities that may induce lactic acidosis, oliguria, or an alteration in mental status.

Multiple organ dysfunction syndrome (MODS)

The presence of altered organ function in an acutely ill patient such that homeo-stasis cannot be maintained without intervention

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