In current scenario which is the most common cause of septicemia?
Correct Answer: Gram negative bacteria
Description: ANSWER: (A) Gram negative bacteriaREF: Harrisons 18th ed chapter 271, various internet referencesAfter having gone through a lot of literature , most of it cites that most common cause of sepsis are gram negative organisms , howerer , the terms sepsis and septicemia have been used quite interchangabily everywhere.If wre stick to very strict definitions of the terms:Most common cause of sepsis (according to US data): gram negative organismsMost common cause of septicemia (organism identified in blood): gram positive organismsSepticemiaPresence of microbes or their toxins in bloodSystemic inflammatory response syndrome (SIRS)Two or more of the folio wing conditions: (1) fever (oral temperature >38degC) or hypothermia (<36aC); (2) tachypnea (>24 breaths/min); (3) tachycardia (heart rate >90 beats/min); (4) leukocytosis (>12,000/L), leucopenia (<4,000/L), or >10% bands; may have a noninfectious etiologySepsisSIRS that has a proven or suspected microbial etiologySevere sepsis (similar to "sepsis syndrome")Sepsis with one or more signs of organ dysfunctionSeptic shockSepsis with hypotension (arterial blood pressure <90 mmHg systolic, or 40 mmHg less than patient s normal blood pressure) for at least 1 h despite adequate fluid resuscitationORNeed for vasopressors to maintain systolic blood pressure 90mmHg or mean arterial pressure 70 mmHgRefractory septic shockSeptic shock that lasts for > 1 h and does not respond to fluid or pressor administrationMultiple-organ dysfunction syndrome (MODS)Dysfunction of more than one organ, requiring intervention to maintain homeostasis
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