Document Detail

Management of sepsis: a 47-year-old woman with an indwelling intravenous catheter and sepsis.
MedLine Citation:
PMID:  21467273     Owner:  NLM     Status:  MEDLINE    
Severe sepsis is the term used to describe the host response to infection when complicated by acute organ dysfunction. Severe sepsis occurs in more than 750,000 individuals in the United States each year, with a hospital mortality of about 30%. Although the classic presentation is of florid shock with frank hypotension, fever, and elevated white blood cell count, many patients can present with cryptogenic shock (shock without hypotension) with more subtle signs of vital organ compromise. Using the case of Ms C, a 47-year-old woman with short gut syndrome and an indwelling intravenous catheter who developed an episode of severe sepsis secondary to a central line infection, treatment of sepsis is discussed. Management consists of prompt intervention with broad-spectrum antibiotics and fluid resuscitation, even in the absence of hypotension, and institution of a variety of strategies in the emergency setting to prevent development or worsening of vital organ dysfunction. Although advances in understanding the host immune response have fueled considerable interest in immunomodulatory therapy, the role of such agents in clinical practice remains limited and controversial.
Derek C Angus
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Publication Detail:
Type:  Case Reports; Clinical Conference; Journal Article     Date:  2011-04-05
Journal Detail:
Title:  JAMA     Volume:  305     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-13     Completed Date:  2011-04-15     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1469-77     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Bacterial Agents / therapeutic use*
Catheterization, Central Venous / adverse effects
Catheters, Indwelling / adverse effects
Fluid Therapy*
Gardner Syndrome
Klebsiella Infections / drug therapy*
Klebsiella pneumoniae / isolation & purification
Middle Aged
Parenteral Nutrition
Sepsis / complications,  drug therapy*
Reg. No./Substance:
0/Anti-Bacterial Agents
Comment In:
JAMA. 2012 Jul 4;308(1):82   [PMID:  22760292 ]

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