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Sepsis is a life-threatening condition caused by the immune response of an
organism to severe infection. Sepsis is characterized by overwhelming
systemic (i.e. not localised) inflammation. It is often associated with
coagulation disorders and dysfunction of the circulatory system. Even under
optimal treatment, dysfunction of many organ systems may progress to
multiple organ failure and eventually death.
Sepsis is particulary common and dangerous in elderly, immunocompromised,
and critically ill patients, where it is a major cause of death in intensive
care units worldwide. In the United States, sepsis is the leading cause of
death in non-coronary ICU patients, while recent 1998 data from the Centers
for Disease Control show that it is the 11th leading cause of death overall.
Mortality rates ranging from 28 to 50% have been reported for sepsis.
The therapy of sepsis rests on antibiotic (and in some cases, surgical)
treatment of the causating infection, fluid replacement, adequate nutrition
(including parenteral nutrition), and appropriate support for organ
dysfunction. This may include hemodialysis in renal failure, mechanical
ventilation in pulmonary dysfunction, transfusion of blood plasma, platelets
and coagulation factors to stabilize blood coagulation, and drug and fluid
therapy for circulatory failure. Therapeutic strategies aimed at the
inflammation process itself have largely failed to improve outcome. However,
the infusion of activated Protein C, a coagulation factor, has recently been
shown to improve survival in sepsis. Low dose cortisol also seems to be beneficial.
* Septicemia (or bacteriemia) is the presence of bacteria in the
bloodstream. Septicemia can occur in sepsis and other serious diseases
such as infective endocarditis, but it may also be a harmless and
* SIRS (Systemic inflammatory response syndrome) is associated with a
variety of causes such as severe trauma, burns, or shock. In its
clinical appearance SIRS may be indistinguishable from sepsis, but a
causating infection is by definition not involved.