Host defense mechanisms of surgical patients. Friend or foe?

Surgeons and members of this society commonly deal with 2 types of infections of great concern in hospitalized patients. These are hospital-acquired pneumonia and intra-abdominal infections. Both of these infections have the potential for severe morbidity and mortality. We have learned how to classify the types of intra-abdominal infections into primary peritonitis, localized abscess with or without peritonitis, diffuse suppurative peritonitis, or combinations of these classifications. Each of these conditions carries a different mortality risk proportional to its severity. We have also learned how to diagnose surgical infections by properly taking medical history and performing physical examination, appropriate laboratory testing, and sophisticated imaging techniques. The treatment of intra-abdominal infections has become fairly standardized and includes surgical or percutaneous drainage of the infected material, correction of the underlying pathologic symptoms, and broad-spectrum empirical antibiotic therapy.