Overview
Definition
Life-threatening organ dysfunction caused by a dysregulated host response to infection.
Epidemiology
A leading cause of death in hospitals. Millions of cases annually worldwide.
Etiology & Risk Factors
- Bacterial infections (Pneumonia, UTI, Intra-abdominal, Skin/Soft tissue)
- Viral infections (e.g., severe COVID-19, Influenza)
- Fungal infections (Candida)
Clinical Symptoms
- Fever or hypothermia
- Tachycardia
- Tachypnea
- Altered mental status
- Hypotension (in Septic Shock)
Clinical Approach
Diagnosis
- SOFA Score increase ≥ 2
- qSOFA (Bedside: RR ≥ 22, Altered mentation, SBP ≤ 100)
- Lactate > 2 mmol/L
- Blood cultures (before antibiotics)
Management
- Hour-1 Bundle: Measure lactate, get blood cultures, administer broad-spectrum antibiotics, begin 30 mL/kg IV crystalloid for hypotension/lactate
- Vasopressors (Norepinephrine is first-line) if hypotensive despite fluids
- Source control (surgery, drain abscess)
Complications
- Septic Shock
- Multiple Organ Dysfunction Syndrome (MODS)
- ARDS
- DIC
- Death