Clinical meaning
Sepsis is life-threatening organ dysfunction from dysregulated host response to infection (Sepsis-3). qSOFA: AMS, SBP <=100, RR >=22. SOFA score >=2 from baseline. Septic shock: sepsis + vasopressors for MAP >=65 + lactate >2 despite adequate fluid. Hour-1 bundle: blood cultures, lactate, broad-spectrum antibiotics, 30 mL/kg crystalloid for hypotension or lactate >=4. Norepinephrine first-line vasopressor.
Diagnosis & workup
Diagnostics & workup: - CT with contrast for abscess, collection, or source identification - Wound/tissue/fluid cultures with Gram stain - Rapid antigen testing (strep, influenza, COVID-19, RSV) - CRP and ESR for inflammatory response quantification - Urinalysis with urine culture and sensitivity - CBC with differential (left shift, leukocytosis, lymphopenia) - Procalcitonin for bacterial infection likelihood
Risk factors: - IV drug use with bacteremia risk - Age extremes (<2 and >65 years with immature/declining immunity) - Splenectomy with encapsulated organism susceptibility - Broad-spectrum antibiotic exposure (C. diff risk factor) - Malnutrition with impaired immune cell production - Diabetes mellitus with impaired neutrophil function - Indwelling medical devices (central lines, urinary catheters, prosthetic joints)