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Bacteremia and Sepsis

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Family Medicine

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Abstract

Bacteremia indicates the presence of viable bacteria in the circulatory blood and is usually defined clinically as positive blood cultures.1 A cascade of local and systemic regulatory mechanisms exist to protect against endothelial damage caused by a variety of nonspecific insults. The systemic inflammatory response syndrome (SIRS) denotes clinical response to endothelial damage including two or more of the following: (1) temperature higher than 38°C or lower than 36°C; (2) respiratory rate more than 20 breaths per minute or a PCO2 less than 32 mm Hg; (3) pulse higher than 90 beats per minute, or (4) white blood cell count more than 12.0 × 109/L or less than 4.0 × 109/L or more than 10% immature neutrophils. When the clinical insult is a documented infection, sepsis is present. As counterregulatory mechanisms fail, endothelial damage progresses leading to severe sepsis (previously the sepsis syndrome), which includes hypotension and hypoperfusion manifested by lactic acidosis, oliguria, or altered mental status. Finally, septic shock occurs when hypotension and hypoperfusion abnormalities persist despite adequate fluid resuscitation.2,3

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Authors
  1. James M. Herman
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  2. William J. Curry
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  3. Edward G. Paul
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Editor information

Editors and Affiliations

  1. Department of Family Medicine, Oregon Health Sciences University, Portland, OR, 97201, USA

    Robert B. Taylor M.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA

    Alan K. David M.D. (The Fred Lazarus, Jr., Professor and Director) (The Fred Lazarus, Jr., Professor and Director)

  3. Department of Family Medicine, St. John’s Mercy Medical Center, St. Louis, MO, 63141, USA

    Thomas A. Johnson Jr. M.D. (Chairman) (Chairman)

  4. Department of Family Medicine, University of Mississippi School of Medicine, Jackson, MS, 39216, USA

    D. Melessa Phillips M.D. (Professor and Chairman) (Professor and Chairman)

  5. Department of Family Medicine, University of California—Irvine College of Medicine, Orange, CA, 92697, USA

    Joseph E. Scherger M.D., M.P.H. (Associate Dean for Primary Care and Chair) (Associate Dean for Primary Care and Chair)

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© 1998 Springer Science+Business Media New York

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Herman, J.M., Curry, W.J., Paul, E.G. (1998). Bacteremia and Sepsis. In: Taylor, R.B., David, A.K., Johnson, T.A., Phillips, D.M., Scherger, J.E. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2947-4_43

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  • DOI: https://doi.org/10.1007/978-1-4757-2947-4_43

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2949-8

  • Online ISBN: 978-1-4757-2947-4

  • eBook Packages: Springer Book Archive

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