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    
Abstract/OtherAbstract:
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.
Authors:
Derek C Angus
Related Documents :
12094173 - Congenital right coronary artery aneurysm causing myocardial infarction, pseudoaneurysm...
17960643 - Percutaneous occlusion of posttraumatic aortic arch pseudoaneurysm by catheter-based de...
7865863 - An evaluation of whether duration of perfusion alters vascular responses in the isolate...
Publication Detail:
Type:  Case Reports; Clinical Conference; Journal Article     Date:  2011-04-05
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     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:  2012-07-05    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1469-77     Citation Subset:  AIM; IM    
Affiliation:
The CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 614 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, USA. angusdc@upmc.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use*
Catheterization, Central Venous / adverse effects
Catheters, Indwelling / adverse effects
Female
Fluid Therapy*
Gardner Syndrome
Humans
Klebsiella Infections / drug therapy*
Klebsiella pneumoniae / isolation & purification
Middle Aged
Parenteral Nutrition
Sepsis / complications,  drug therapy*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
JAMA. 2012 Jul 4;308(1):82   [PMID:  22760292 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Pacific islanders' perceived risk of cardiovascular disease and diabetes.
Next Document:  Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hys...