Clinical features and general management of patients with severe infections

This chapter examines how the host response to a severe infection involves an intricate link between the inflammatory and coagulation systems, and mechanisms designed to limit damage to normal tissues. Although originally describing both localized and disseminated infections, the term sepsis is now more commonly used to describe the systemic response to a severe infection. The symptoms and signs of sepsis include fever and rigors, flushing and vasodilation, an elevated heart and respiratory rate, confusion, hypotension, and oliguria. To these are added symptoms and signs relating to the specific infection site and pathogenic organism. The initial diagnosis of sepsis is largely clinical. The immediate treatment involves intravenous fluids, appropriate antibiotics and control of the source of infection. Culture results may allow refinement of antibiotic treatment. Treatment guidelines are available and updated regularly.