Sepsis
Fever, jaundice and right upper quadrant pain (Charcot's triad) with hypotension is acute ascending cholangitis with sepsis.
Treatment at a glance
- Within one hour: cultures, IV broad-spectrum antibiotics (e.g. ceftriaxone ± gentamicin, or piperacillin–tazobactam)
- IV fluids 30 mL/kg for hypotension or high lactate
What our notes say
- Fever, jaundice and right upper quadrant pain (Charcot's triad) with hypotension is acute ascending cholangitis with sepsis. (Treatment of Infectious Disease: 5-case clinical quiz)
- Sepsis is the commonest indirect cause of ARDS, acting through the blood. (Internal Medicine Respiratory CAT 1: 30 MCQs and 5 short answer questions)
- Parapneumonic effusion and empyema, lung abscess, sepsis and septic shock, respiratory failure and ARDS, pleurisy, pericarditis, lobar collapse, metastatic infection (meningitis, endocarditis, arthritis), bronchiectasis (long term). (Pneumonia)
- Timing matters: in severe pneumonia give the first antibiotic dose within 4 hours (sooner in sepsis), and take blood cultures first if this does not delay treatment. (Pneumonia)
- Empyema and bronchopleural fistula, massive haemoptysis, spread (brain abscess, meningitis), sepsis, amyloidosis (chronic), chronic cavity that becomes colonised by *Aspergillus* (aspergilloma), recurrent infection. (Lung Abscess)
- Hypercoagulability (cancer, pregnancy and the pill, thrombophilia, nephrotic syndrome, sepsis, HIV, TB). (DVT and Venous Thromboembolism (with Pulmonary Embolism))
Study material on Sepsis
- Sepsis and septic shock
- Liver Histology & Physiology
- Liver Histology & Physiology
- Integrated case paper: Medicine, Surgery, Gynaecology and Paediatrics (160 marks)
- Paediatrics Year 4 MBChB end of semester CAT: triage, newborn care, growth and development, 30 MCQs and 5 short answers
- End Sem Cat: Respiratory Pathology: Emphysema, ARDS, Pneumoconiosis
- Paediatrics end of first trimester exam (MBPE 4300): 27 November 2018, 49 of 50 MCQs
- Paediatrics main exam (MBPE 4300): 24 January 2022, Paper One, 100 MCQs, 2 short essays and 2 long essays
- Acute kidney injury
- Safe motherhood, maternal and newborn health
- Respiratory System Pathology 1A — Practice Questions
Practice questions on Sepsis
An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery. What is the most likely source of the organism?
- Contaminated intravenous fluids
- Contaminated respiratory equipment
- Nasal carriage by healthcare workers
- A contaminated milk formula
Answer: C. Staphylococcus aureus is a common colonizer of the nasal passages. Healthcare workers with nasal carriage can transmit the organism to vulnerable newborns, leading to sepsis.
An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery. What is the most likely source of the organism?
- Nose
- Colon
- Hand
- Throat Answer:
Answer: A. The anterior nares are the classic carriage site (reservoir) for *S. aureus* in both patients and healthcare workers, and a common outbreak source in nurseries. --- ---
A neonate born to a mother with prolonged rupture of membranes develops sepsis. The organism showing beta-hemolysis and being CAMP positive is
- Enterococcus faecalis
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Streptococcus agalactiae
- causes early-onset neonatal sepsis and meningitis, particularly after prolonged membrane ruptur
Answer: E. Group B Streptococcus (S. agalactiae) causes early-onset neonatal sepsis and meningitis, particularly after prolonged membrane rupture. It is identified by beta-hemolysis, CAMP test positivity, and resistance to bacitracin. ---
An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery. You are called upon to investigate. According to your knowledge of the normal flora, what is the most likely source of the organism?
- Nose
- Colon
- Hand
- Throat
- Mostly unchanged in early disease
Answer: A. The anterior nares (nose) is the primary reservoir for S. aureus colonization, occurring in 20-40% of healthy adults. Healthcare workers can transmit the organism from their nose to patients via hands, making nasal carriage the most likely source in nosocomial outbreaks. ---
An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery. What is the most likely source of the organism?
- Nose
- Colon
- Hand
- Throat
- Primarily an incidental laboratory finding
Answer: A. S. aureus is commonly carried asymptomatically in the anterior nares (nose) of 20-40% of healthy individuals. Healthcare workers' nasal carriage is often the source of nosocomial outbreaks in nurseries. ---
An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery. What is the most likely source of the organism?
- Contaminated intravenous fluids
- Healthcare worker's hands
- Airborne droplets from an infected staff member
- A sterile surgical instrument
Answer: B. Staphylococcus aureus is commonly found on the skin and in the nasal passages of healthy individuals, including healthcare workers. Poor hand hygiene is a frequent route of transmission in healthcare settings, especially in vulnerable populations like newborns.