Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Explore these free sample topics:
-- The first section of this topic is shown below --
- Sepsis (Greek, putrefaction): life-threatening organ dysfunction caused by host response to infection.
- Septic shock: a subset of sepsis in which underlying circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than sepsis alone.
- Risk of sepsis is associated with both virulence of pathogen and immunologic vulnerabilities of host.
- Pathogens are associated with site of antecedent infection: not comprehensive list
- Gram-negative bacteria: E. coli, Klebsiella, Enterobacter, Pseudomonas, Serratia
- Gram-positive bacteria: Staphylococcus aureus, S. pneumoniae, Streptococcus species
- Toxin mediated: Staphylococcal or streptococcal toxic shock, Clostridium difficile, Clostridium sordellii.
- Viral: influenza A, human metapneumovirus, coronavirus, and respiratory syncytial virus
- Fungal: candida
- Rickettsial: R. rickettsii, R. typhi
- Consider both (1) hosts with recognized vulnerabilities and (2) exposures to pathogens of recognized virulence.
- Maternal and neonatal: Group B streptococci, E. coli., Group A streptococci (puerperal sepsis)
- Injection drug users: S. aureus, esp. MRSA, and Candida
- Splenectomized or functionally asplenic pts: Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Capnocytophaga canimorsus,Babesia spp.
- Neutropenic: GNB, Aspergillus.
- Traveler: malaria, salmonellosis.
- Healthy young adult: toxic shock syndromes (S. aureus or group A strep), N. meningitidis, bioterrorism (anthrax, plague), Hantavirus, severe influenza +/- bacterial superinfection.