- Sepsis is defined as SIRS secondary to suspected or proven infection.
Diagnosis of infection itself is driven by clinical circumstances, positive cultures,
notable findings on imaging, and physical exam. It should be stressed that
suspicion of infection alone is sufficient to establish the diagnosis of sepsis and
initiate timely therapy. Pediatric definition of infection includes any or all of the
following: positive fluid or tissue cultures; presence of inflammatory cells in
otherwise sterile fields, such as CSF, pleural or peritoneal space; radiographic
evidence of pulmonary infiltrates, anastomotic complications, viscus perforation,
or superficial and deep space abscesses; cellulitis, subcutaneous emphysema
suggesting underlying necrotizing process, petechia, or purpura fulminans. - Severe sepsis includes all of the SIRS/sepsis criteria with evidence of
single or multi-organ dysfunction. Pediatric guidelines require a presence of
either cardiovascular or respiratory compromise, or presence of 2 or more other
end organ dysfunction, as outlined in the table below. - Septic shock is the final progression of untreated sepsis or severe
sepsis unresponsive to initial fluid resuscitation.
marcin
(Marcin)
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