ACUTE SEPSIS AND ITS CLINICAL VARIATIONS
DOI:
https://doi.org/10.11603/1681-2727.2022.4.13704Keywords:
sepsis, septicemia, septicopyemia, septic (infectious) endocarditis, clinical manifestations, diagnosis, clinical caseAbstract
The problem of acute sepsis as a polyetiological acyclic disease with peculiar clinical symptoms and diagnostic difficulties, which requires special treatment, is considered. The predictors of acute sepsis and the variety of clinical manifestations of its two classical stages – septicemia and septicopyemia – are characterized in detail.
A typical case of acute sepsis, which was diagnosed only later, is given. In this regard, etiotropic therapy was delayed. Therefore, despite powerful etiotropic therapy, the disease was not limited to acute sepsis, but continued in the form of infectious (septic) endocarditis.
The septic nature of infectious endocarditis is due to the presence and persistence of a septic focus in the endocardium, as well as the course of the disease in the form of continuous growth of local inflammatory and destructive changes in primary septic foci and general infectious-metastatic, thromboembolic and immune complex manifestations, which in the absence of special treatment lead to an inevitable fatal outcome, that is, the development of a disease such as sepsis acyclicity.
The diagnosis of infective endocarditis is based on the detection of initially reasonably suspicious clinical and then evident paraclinical signs of the disease. Classical clinical and morphological signs of infectious endocarditis, as well as general principles of therapy of such patients, are given.
References
Rebenok, Zh. A. (2007). Sepsis: modern problems. Minsk: Chetyre chetverti [in Russian].
Bochorishvili, V. G. (1998). Sepsisology with the basics of infectious pathology. Tbilisi: Metsniyereba [in Russian].
Kopcha, V. S. (2018). Sepsis – syndrome or infectious disease? Evolution of dilem. Infektsiyni khvoroby – Infectious Diseases, 4 (94), 33-43 [in Ukrainian].
Robertson, C. M., & Coopersmith, C. M. (2006). The systemic inflammatory response syndrome. Microbes and Infection, 8 (5), 1382-1389. DOI: https://doi.org/10.1016/j.micinf.2005.12.016
Kaukonen, K. M., Bailey, M., Pilcher, D., Cooper, D. J., & Bellomo, R. (2015). Systemic inflammatory response syndrome criteria in defining severe sepsis. New England Journal of Medicine, 372(17), 1629-1638. DOI: https://doi.org/10.1056/NEJMoa1415236
Rebenok, Zh. O. (2008). Sepsis: Recognition and treatment. Infektsiyni khvoroby – Infectious Diseases, 3, 53-59 [in Ukrainian].
Rebenok, Zh. O. (2010). Modern resuscitation: opportunities for improvement. Infektsiyni khvoroby – Infectious Diseases, 2, 85-88 [in Ukrainian].
Iung, B. (2019). Infective endocarditis. Epidemiology, pathophysiology and histopathology. Presse Medicale (Paris, France: 1983), 48 (5), 513-521. DOI: https://doi.org/10.1016/j.lpm.2019.04.009
Afeke, I., Adu-Amankwaah, J., Nyarko, M., Bushi, A., Ablordey, A. S., Duah, P. A., ... & Orish, V. N. (2022). Acinetobacter baumannii-induced infective endocarditis: new insights into pathophysiology and antibiotic resistance mechanisms. Future Microbiology, 17 (16), 1335-1344. DOI: https://doi.org/10.2217/fmb-2021-0279
Bomsztyk, K., Mar, D., An, D., Sharifian, R., Mikula, M., Gharib, S. A., ... & Denisenko, O. (2015). Experimental acute lung injury induces multi-organ epigenetic modifications in key angiogenic genes implicated in sepsis-associated endothelial dysfunction. Critical care, 19(1), 1-13. DOI: https://doi.org/10.1186/s13054-015-0943-4
Tyurin, V. P. (2002). Infective endocarditis. Moscow: Geotar-Med, 222 p. [in Russian].
Müller, A. M., Cronen, C., Kupferwasser, L. I., Oelert, H., Müller, K. M., & Kirkpatrick, C. J. (2000). Expression of endothelial cell adhesion molecules on heart valves: up-regulation in degeneration as well as acute endocarditis. The Journal of pathology, 191 (1), 54-60. DOI: https://doi.org/10.1002/(SICI)1096-9896(200005)191:1<54::AID-PATH568>3.0.CO;2-Y
ICD-11. International classification of diseases 11th revision. (2022). Retrieved from https://icd11.ru/endokardit-mkb11/ [in Russian].
Watanakunakorn, C. (1994). Staphylococcus aureus endocarditis at a community teaching hospital, 1980 to 1991: an analysis of 106 cases. Archives of Internal Medicine, 154 (20), 2330-2335. DOI: https://doi.org/10.1001/archinte.154.20.2330
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler Jr, V. G., Tleyjeh, I. M., Rybak, M. J., ... & American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation, 132 (15), 1435-1486. DOI: https://doi.org/10.1161/CIR.0000000000000296
Rudasill, S. E., Sanaiha, Y., Mardock, A. L., Khoury, H., Xing, H., Antonios, J. W., ... & Benharash, P. (2019). Clinical outcomes of infective endocarditis in injection drug users. Journal of the American College of Cardiology, 73(5), 559-570. DOI: https://doi.org/10.1016/j.jacc.2018.10.082
Martín-Dávila, P., Fortún, J., Navas, E., Cobo, J., Jiménez-Mena, M., Moya, J. L., & Moreno, S. (2005). Nosocomial endocarditis in a tertiary hospital: an increasing trend in native valve cases. Chest, 128 (2), 772-779. DOI: https://doi.org/10.1378/chest.128.2.772
Pierce, D., Calkins, B. C., & Thornton, K. (2012). Infectious endocarditis: diagnosis and treatment. American Family Physician, 85 (10), 981-986.
Durack, D. T., Luses, A. S., Bright, D. K. (1994). New eriterid for diagnosis of infective endocarditis: utilisation of specific echocardiographic findings. Duke Endocarditis Servise. Ann. J. Med., 96, 200-209. DOI: https://doi.org/10.1016/0002-9343(94)90143-0
Vinogradova, T. L., Chapigina, N. S. (1998). Subacute infective endocarditis – diagnostic issues. Terapevticheskiy arkhiv – Therapeutic Archive, 6, 35-38. [in Russian].
Iversen, K., Ihlemann, N., Gill, S. U., Madsen, T., Elming, H., Jensen, K. T., ... & Bundgaard, H. (2019). Partial oral versus intravenous antibiotic treatment of endocarditis. New England Journal of Medicine, 380 (5), 415-424. DOI: https://doi.org/10.1056/NEJMoa1808312
Pettersson, G. B., & Hussain, S. T. (2019). Current AATS guidelines on surgical treatment of infective endocarditis. Annals of cardiothoracic surgery, 8 (6), 630. DOI: https://doi.org/10.21037/acs.2019.10.05
Rebenok, Zh. O., Andreychyn, M. A., Kopcha, V. S. (2003). Principles of rational antibiotic therapy. Ternopil: Ukrmedknyha, 43 p. [In Ukrainian].
Malhotra, K., & Yerram, P. (2019). Plasmapheresis and corticosteroids in infective endocarditis-related crescentic glomerulonephritis. BMJ Case Reports CP, 12 (3), e227672. DOI: https://doi.org/10.1136/bcr-2018-227672
Regazzoni, V., Loffi, M., Garini, A., & Danzi, G. B. (2020). Glucocorticoid-Induced Bacterial Endocarditis in COVID-19 Pneumonia – Something to Be Concerned About?. Circulation Journal, 84 (10), 1887. DOI: https://doi.org/10.1253/circj.CJ-20-0462
Rasmussen, R. V. (2011). Anticoagulation in patients with stroke with infective endocarditis is safe. Stroke, 42 (6), 1795-1796. DOI: https://doi.org/10.1161/STROKEAHA.110.611681
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Infectious diseases
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal Infectious Disease (Infektsiini Khvoroby) allows the author(s) to hold the copyright without registration
Users can use, reuse and build upon the material published in the journal but only for non-commercial purposes
This journal is available through Creative Commons (CC) License BY-NC "Attribution-NonCommercial" 4.0