SEPSIS – SYNDROME OR INFECTIOUS DISEASE? EVOLUTION OF DILEM

Abstract

The aim of the study is to draw the attention of physicians to the discrepancy between the «new» notions about sepsis imposed on the medical community and definitely accepted not only by anesthetists, resuscitative surgeons and surgeons, but also by many infectionists.

By defining the cornerstone of sepsis as the «systemic» of the inflammatory response in the form of cytokine violations, the authors of the corresponding concept are forced to recognize the etiological factors almost all without exception, pathogens of infectious diseases (from viruses to the simplest), which naturally go with the increased activity of cytokines in serum. Without diminishing the importance of these important components of inflammation, one should pay attention to the postulate that not only viruses and protozoa never cause sepsis, but also all «non-bacterial pathogens» (clostridia of botulism and tetanus, borthetels of whooping cough, diphtheria sticks, cholera vibrios, etc.) by definition, there are no etiological factors of this disease, although they necessarily lead to severe systemic reactions accompanied by an increase in the level of proinflammatory cytokines.

Therefore, sepsis is a generalized acyclic infectious disease of the bacterial and / or fungal etiology that develops in an immunodeficient organism with characteristic pathomorphological and pathologist changes in organs and tissues.

A detailed analysis of the clinical case of sepsis in a young woman is presented, which, due to adequate active surgical and powerful and long-term conservative therapy, has safely recovered.