Severe sepsis

Sepsis refers to a generalized infection caused by penetration in the bloodstream, continuously or intermittently, of pathogens and their toxins from a septic centre, clinically manifested as infectious toxicities which have a very serious development. It is favored by surgery, operations and non invasive exploration and strong state of immunosuppression. Mortality is approximately 30-80%, a grim prognosis occurring in gram-negative infections.

Favorable conditions for developing sepsis are:

- Surgery and other tests (endoscopy, endourology, vascular catheterization, tracheostomy, etc.).

- State of immunosuppression (corticosteroids, chemotherapy, radiation, etc.).

- Organic defects (diabetes, nutritional deficits, etc.).

- Presence of a known septic focus or a cryptogenic one (unmanifested)

- Preoperative use of heterologous materials (synthetic materials, bone or joint prostheses, vascular prostheses of plastics - are necessary adjusted for their early disposal)

- Failure to comply with health regulations in hospitals.

Sepsis is characterized by the following components:

- Gateway: exogenous (infected wounds or burns, skin infections, or mucous membranes, etc.).

- Septic focus, external or internal, where multiplication occurs with overflow of germs in the bloodstream and lymphatic system (along with toxins)

- Dissemination (septic metastases) - located in the lung, liver, spleen, etc.

- Severe general events.

The main pathological features of sepsis are often found at necropsy lesions.

Diagnosis

A positive diagnosis of sepsis involves: septic outbreak, clinical signs, and positive blood cultures.

Sepsis and septicemia are considered to refer to a number of pathological conditions caused by bacteremia. In medical practice the terms are used together to define the same condition.

Sepsis is a response to infection caused by any class of microorganisms. Microbial invasion of the bloodstream is not essential for the development of sepsis, local or systemic spread of the molecules that signal the presence of microbes or toxins can also cause the response.

Systemic inflammatory response syndrome may have a noninfectious etiology.

Sepsis is a clinical syndrome that refers to severe infection and is characterized by systemic inflammation and spread tissue injury. In this syndrome the tissue is isolated from primary injury which mounted signs of inflammation such as vasodilation, increased microvascular permeability and leukocyte accumulation.

Impaired organ dysfunction may vary widely from moderate up to failure.

Pathogenesis of sepsis - sepsis and organ dysfunction

Sepsis is defined as a malignant process of systemic inflammation. A deficient immune defense may allow infection to develop.

Sepsis is described as a process that allows extension of infection involving normal tissues.

Target organ damage: organ dysfunction or organ failure may be the first sign of sepsis or organ is not immune to the consequences of excessive inflammatory sepsis.

Acute renal failure frequently accompanies sepsis with acute tubular necrosis.