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[Septicemia and systemic inflammatory response]

P Pierucci1, M Marroni, R Papili

  • 1Istituto di Clinica delle Malattie Infettive, Università, Perugia.

Recenti Progressi in Medicina
|August 6, 1998
PubMed
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Severe systemic inflammatory response syndrome (SIRS) in patients with endocarditis or septicemia significantly increases mortality. Differentiating between infection response and persistent bacteremia is crucial for accurate diagnosis and treatment outcomes.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pathophysiology

Context:

  • Endocarditis and septicemia are serious infections with potential systemic complications.
  • Systemic Inflammatory Response Syndrome (SIRS) is a complex host response to infection.
  • The terminology surrounding sepsis and its related syndromes has evolved and can be ambiguous.

Purpose:

  • To investigate the relationship between endocarditis/septicemia and the development of SIRS, septic shock, and Multiple Organ Dysfunction Syndrome (MODS).
  • To analyze mortality rates in HIV-negative patients with endocarditis/septicemia based on the presence and severity of SIRS.
  • To clarify the definition and clinical utility of SIRS in the context of severe infections.

Summary:

  • A retrospective analysis of 196 HIV-negative patients with endocarditis/septicemia was conducted.

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  • Patients with endocarditis without severe SIRS/septic shock had no deaths, while those with severe SIRS/septic shock had 3 deaths (P=0.052).
  • Septicemia patients with severe SIRS/septic shock exhibited a 12.3% mortality rate, with higher mortality in septic shock (16.6%) compared to severe SIRS (11.4%) (P=0.003).
  • Impact:

    • The findings support the continued justification of the historical definition of septicemia as persistent bacteremia.
    • "Infective SIRS" and "severe infective SIRS" can accurately describe host responses to infection.
    • Excessive or "severe infective SIRS" is linked to increased risk of septic shock, organ failure, and mortality, highlighting the importance of precise diagnostic terminology.