Introduction
General purulent infection, or sepsis, is a life-threatening condition in which the body's response to an infection becomes dysregulated and causes organ dysfunction. This note covers definition and classification, etiology, pathogenesis, clinical picture, diagnosis, treatment and the particular features of abdominal sepsis. Local purulent processes such as phlegmon and abscess belong to the preceding topics and are mentioned here only as possible sources.
Definition and classification
According to the current consensus definition (Sepsis-3, 2016), sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Operationally, it means a suspected or proven infection together with an acute rise in the SOFA score of 2 or more points. The older terms SIRS, severe sepsis and septic shock are still used in practice and in exams.
- Sepsis: infection plus acute organ dysfunction (SOFA rise of 2 or more).
- Septic shock: sepsis requiring vasopressors to keep mean arterial pressure at 65 mmHg or above, with lactate above 2 mmol/L despite adequate fluid resuscitation. Hospital mortality is markedly higher than in sepsis alone.