Infection - Acute Sepsis Flashcards
What is the definition of sepsis?
Life-threatening organ dysfunction due to a dysregulated host response to infection
What is septic shock?
Persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation
What is bacteraemia?
The presence of bacteria in the blood
What should be done if a patient has ‘red flag sepsis’?
- inform senior doctor for review
- send urgent investigations
- complete sepsis six bundle
What is included in the sepsis six bundle?
- oxygen
- blood cultures
- IV antibiotics
- fluid challenge
- lactate
- measure urine output
Give some examples of urgent investigations that might be carried out in someone suspected of having sepsis
- full blood count, urea and electrolytes
- EDTA bottle for PCR
- blood sugar
- liver function tests
- C-reactive protein
- coagulation studies
- blood gases
- other microbiology samples
Why do many bacteria have a lipopolysaccharide capsule?
It promotes adherence and prevents phagocytosis, protecting it from the body’s defence systems
What would be the local response to endotoxins binding to macrophages?
Tissue necrosis factors, interleukins and cytokines stimulate inflammatory response to promote wound repair and recruit reticular endothelial system
What would be the systemic response to endotoxins binding to macrophages?
Cytokines would be released into the circulation, stimulating growth factor, macrophages and platelets
Why is sepsis often associated with microvascular injury?
Cytokines initiate production of thrombin and promote coagulation. Cytokines also inhibit fibrinolysis, so the coagulation cascade leads to microvascular thrombosis and therefore organ ischaemia, dysfunction and failure
What is the antibiotic most often used in adults with meningitis?
Ceftriaxone
Give some life threatening complications of sepsis
- irreversible hypotension
- respiratory failure
- acute kidney failure
- raised intracranial pressure
- ischaemic necrosis of digits/hands/feet
How is meningitis spread?
Via aerosols and nasopharyngeal secretions
What are the three available pathways following ‘acquisition’ of meningococcal bacteria?
Clearance - cleared from body/throat
Carriage - carried in throat without symptoms
Invasion - enters body and causes symptoms
Give two ways of preventing the spread of meningitis
- vaccination
- antibiotic prophylaxis
