医学英语阅读：败血症

septicemia

alternative names

blood poisoning; bacteremia with sepsis

definition

septicemia is the presence of bacteria in the blood (bacteremia) and is often associated with severe disease.

causes, incidence, and risk factors

septicemia is a serious, rapidly progressing, life-threatening infection that can arise from infections throughout the body, including infections in the lungs, abdomen, and urinary tract. it may precede or coincide with infections of the bone (osteomyelitis), central nervous system (meningitis), or other tissues.

septicemia can rapidly lead to septic shock and death. septicemia associated with some organisms such as meningococci can lead to shock, adrenal collapse, and disseminated intravascular coagulopathy, a condition called waterhouse-friderichsen syndrome.

septicemia can begin with spiking fevers and chills, rapid breathing and heart rate, the outward appearance of being seriously ill (toxic) and a feeling of impending doom. these symptoms rapidly progress to shock with decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood-clotting

abnormalities evidenced by hemorrhagic lesions in the skin (petechiae and ecchymosis).

symptoms

* fever (sudden onset, often spiking)

* chills

* toxic looking (looks acutely ill)

* changes in mental state

o irritableo lethargic

o anxious

o agitated

o unresponsive

o comatose

* shock

o cold

o clammy

o pale

o cyanotic (blue)

o unresponsive

* skin signs associated with clotting abnormalities

o petechiae

o ecchymosis (often large, flat, purplish lesions that do not blanch when pressed)o gangrene (early changes in the extremities suggesting decreased or absent blood flow)

* decreased or no urine output

signs and tests

physical examination may show：

* low blood pressure

* low body temperature or fever

* signs of associated disease (meningitis, epiglottitis, pneumonia, cellulitis, or others)

tests that can confirm infection include：

* blood culture

* urine culture

* csf culture

* culture of any suspect skin lesion

* cbc

* platelet count