[Early recognition of sepsis; a diagnostic challenge for the general practitioner]

Early recognition and treatment of sepsis is essential to prevent morbidity and mortality. Many sepsis patients are initially assessed by a general practitioner (GP). Delay can be prevented if patients are referred to the hospital as soon as possible. However, signs and symptoms of sepsis can be subtle or aspecific, complicating the distinction between patients who need urgent care and patients who can be safely treated at home. We describe three patients who were admitted to the intensive care after repeated assessment by GPs in an out-of-hours setting: a 76-year-old man who was diagnosed with urosepsis, an 86-year-old man who was diagnosed with pneumosepsis and a 49-year-old man who was admitted after cardiopulmonary resuscitation due to sepsis. In all cases risk factors and signs of sepsis were present, but the sepsis had not been recognized until presentation to the hospital.