Severe Sepsis Essay

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SEVERE SEPSIS SURVIVAL: A CASE STUDY, FROM HOPELESSNESS TO HOPEFULNESS.

Halima K,1 Iliyasu G,2 Farouq MD,2
1Intensive Care Unit, Aminu Kano Teaching Hospital
2Infectious Disease Unit, Aminu Kano Teaching Hospital

INTRODUCTION
 Sepsis is a serious medical condition characterized by a whole body inflammatory state (called a systemic inflammatory response or SIRS) and the presence of a known or suspected infection.
 The body may develop this inflammatory response to microbes in the blood, urine, skin or other tissues.
 Sepsis is a complex medical condition starting from an infectious stimulus and resulting in an exaggerated immune response
 Severe sepsis is one of the most common reasons for critically
Therefore, early recognition of sepsis is of paramount importance in reducing mortality.

BACKGROUND
 A fourteen year old student presented to emergency room with 5 days history of fever and 4hours history of focal seizures with secondary generalisation, five days prior he had symptoms of upper respiratory tract infection.
 He was acutely ill looking with auxiliary temperature of 38.90c and stable vital signs.
 Rapid deterioration was noted over 6hrs while in ER, necessitating transfer to ICU with GCS of 4/15, RR 30cycles/min, PR 100 bpm, BP 60/40mmHg. Brain Computerised Tomography showed Lt fronto-parietal subdural collection about 10mm in its widest diameter, mid line shift & hypo dense region on the Lt occipitor-parietal region in keeping with an abscess collection.
 WBC 21.6x109 with 89.6% neutrophils, platelets 229x106, two sets of blood culture yielded Staphylococcus aureus.
 Was put on mechanical ventilator, received fluid resuscitation with dopamine infusion, initial empirical antibiotic (ceftriazone) changed to intravenous cloxacillin and abscess drained via a mini burr hole.
PATHOPHYSIOLOGY
 Two major injuries occur in
Sepsis is one of the leading killers in our ICUs and, worryingly, the number of cases of sepsis is increasing around the globe.
 In this particular case, the unit did its best to help the patient get better after his first surgery. He had a burst abdomen and a second surgery and later returned back to the ICU.
 His prognosis at this time was bleak; what struck us most was the patient’s fighting spirit- his strong will to live! This was apart from the financial constraint and overall condition.
 At the end the management and the entire Staff were quite happy, cos he made a remarkable improvement and was discharged home after a month of rehabilitation in the surgical ward.
 Mortality rates in septic shock remain high, and survivors often suffer long-term health consequences such as cognitive decline, increased risk of infection, and reduced functional capacity IN THE