[Sepsis: state of the art, diagnosis and disputable problems of classification]

Area of Science:

• Infectious Diseases
• Pathology
• Microbiology

Context:

• Sepsis is a complex systemic infection with varied clinical presentations.
• Microbial agents like Streptococcus and Staphylococcus are primary causes of septicopyemia.
• Gram-negative bacteria induce endotoxin shock, a distinct form of sepsis.

Purpose:

• To differentiate the etiological agents and pathological criteria of sepsis.
• To distinguish between septicopyemia and endotoxin shock based on morphological findings.
• To clarify the nosological status of subacute septic endocarditis.

Summary:

• Sepsis, characterized by diverse manifestations, is often provoked by Streptococcus and Staphylococcus species, leading to septicopyemia with metastatic purulent foci as a key indicator.
• Gram-negative bacterial infections result in endotoxin shock, with disseminated intravascular coagulation (DIC) and hypophysis-adrenal system damage signifying generalization.
• Subacute septic endocarditis, an immunocomplex disease, requires differentiation from acute bacterial endocarditis in septicopyemia.

Impact:

• Improved understanding of sepsis pathogenesis and classification.
• Enhanced diagnostic criteria for differentiating sepsis subtypes.
• Clinical guidance for distinguishing subacute septic endocarditis from other forms of bacterial endocarditis.