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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.
Bacteremia frequently evokes a response from the immune system called sepsis, which consists of symptoms such as fever, chills, and hypotension. [8] Severe immune responses to bacteremia may result in septic shock and multiple organ dysfunction syndrome, [8] which are potentially fatal.
Delaying initiation of vasopressor therapy during septic shock is associated with increased mortality. [73] Norepinephrine is often used as a first-line treatment for hypotensive septic shock because evidence shows that there is a relative deficiency of vasopressin when shock continues for 24 to 48 hours. [74]
Other sites involved in septic metastasis and abscess formation are the muscles and soft tissues, liver, spleen, kidneys and nervous system (intracranial abscesses, meningitis). [5] Production of bacterial toxins such as lipopolysaccharide leads to secretion of cytokines by white blood cells which then both lead to symptoms of sepsis.
In septic shock the blood flow in the microvasculature is abnormal with some capillaries underperfused and others with normal to high blood flow. [5] The endothelial cells lining the blood vessels become less responsive to vasoconstrictive agents, lose their glycocalyx (normal coating) and negative ionic charge, become leaky and cause extensive ...
Most commonly, the infection is bacterial, but it may also be fungal, viral, or protozoan. [3] Common locations for the primary infection include the lungs, brain, urinary tract , skin, and abdominal organs .
Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. [1] Symptoms may include fever , rash , skin peeling , and low blood pressure . [ 1 ] There may also be symptoms related to the specific underlying infection such as mastitis , osteomyelitis , necrotising fasciitis , or pneumonia .
Example of a workup algorithm of possible bacterial infection in cases with no specifically requested targets (non-bacteria, mycobacteria etc.), with most common situations and agents seen in a New England setting. Main Streptococcus groups are included as "Strep." at bottom left. Diagnosis is by a swab of the affected area for laboratory testing.