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Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
The risk of death from sepsis is as high as 30%, while for severe sepsis it is as high as 50%, and the risk of death from septic shock is 80%. [ 14 ] [ 15 ] [ 6 ] Sepsis affected about 49 million people in 2017, with 11 million deaths (1 in 5 deaths worldwide). [ 16 ]
The cause in children is typically unknown; in adults a lead point is sometimes present. [1] Risk factors in children include certain infections, diseases like cystic fibrosis, and intestinal polyps. [1] Risk factors in adults include endometriosis, bowel adhesions, and intestinal tumors. [1] Diagnosis is often supported by medical imaging. [1]
Pneumonia and sepsis are the most common triggers, and pneumonia is present in up to 60% of patients and may be either causes or complications of ARDS. Alcohol excess appears to increase the risk of ARDS. [47] Diabetes was originally thought to decrease the risk of ARDS, but this has shown to be due to an increase in the risk of pulmonary edema.
Both SIRS and sepsis could ultimately progress to multiple organ dysfunction syndrome. In one-third of the patients, however, no primary focus can be found. [1] Multiple organ dysfunction syndrome is well established as the final stage of a continuum: SIRS + infection → sepsis → severe sepsis → Multiple organ dysfunction syndrome.
In children the presence of cyanosis, rapid breathing, poor peripheral perfusion, or a petechial rash increases the risk of a serious infection by greater than 5 fold. [43] Other important indicators include parental concern, clinical instinct, and temperature greater than 40 °C.
Purpura fulminans is a presenting feature of severe acute sepsis, such as Neisseria meningitidis, Streptococcus pneumoniae, Group A and B Streptococci, and less commonly with Haemophilus influenzae, Staphylococcus aureus, Capnocytophaga canimorsus [8] or Plasmodium falciparum (malaria) infections, particularly in individuals with asplenia.
Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs.