These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis. Continue reading
Post-Traumatic Stress Disorder (PTSD) is a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock, typically involving disturbance of sleep and constant vivid recall of the experience, with dulled responses to others and to the outside world.
I. Streptococcal TSS
A. Isolation of group A Streptococcus
1. From a sterile site
2. From a nonsterile body site
B. Clinical signs of severity
2. Clinical and laboratory abnormalities (requires two or more of the following):
a) Renal impairment
c) Liver abnormalities
d) Acute respiratory distress syndrome
e) Extensive tissue necrosis, i.e., necrotizing fasciitis
f) Erythematous rash
An illness with the following clinical manifestations:
Fever: temperature > 38.9º C (102º F)
Rash: diffuse macular erythroderma
Desquamation: 1-2 weeks after onset of illness, particularly palms and soles
Hypotension: systolic blood pressure < 90 mm Hg for adults or less than fifth percentile by age for children <16 years of age; orthostatic drop in diastolic blood pressure greater than or equal to 15 mm Hg from lying to sitting, orthostatic syncope, or orthostatic dizziness
A 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus panel defined the following terms which are relevant to the discussion of septic shock:
Infection: Infection is a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms.
Bacteremia: Bacteremia refers to the presence of viable bacteria in the blood.
Systemic inflammatory response syndrome: Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory response to a variety of severe clinical insults. This syndrome is clinically recognized by the presence of two or more of the following: