Sepsis induced by invasive infection is a challenging problem and the major cause of death after severe burn. With the increasing understanding of sepsis, diagnostic criteria of sepsis were proposed and revised consecutively so that they could be consistent with the clinical practice. Being different from other trauma and critical diseases, diagnostic criteria of sepsis after severe burn were also proposed, and they need further clinical verification. It is believed that comprehensive measures for the treatment of severe sepsis after burn should be advocated. These measures include rapid and effective resuscitation of burn shock, early escharotomy and closure of burn wound, metabolic support, immunoregulation and anti-inflammation, reinforcement of organ support, etc. Although a number of advances have been achieved in the past decades, the mechanism of sepsis need further elucidation, diagnostic criteria of sepsis need further revision, and novel therapeutic measures for burn sepsis should be developed.
Burns ; complications ; Humans ; Sepsis ; diagnosis ; etiology ; therapy

Pediatric burn patients account for more than 1/3 of the inpatients in the same period, and its incidence surpasses that of burn patients in other age groups. However, it brings about much difficulty to treat pediatric burn patients complicated by sepsis, which brings a significantly higher mortality than that of the adult. Moreover, the physiological characteristics, development of organs, drug metabolism, and body response to burn injury in children are obviously different from those of the adult. Therefore, it is clinically important to understand the clinical characteristics of sepsis in pediatric burn patients in order to improve the diagnosis and treatment of this ailment.
Burns ; complications ; Child ; Humans ; Sepsis ; diagnosis ; etiology

Since the definition of sepsis was proposed in Chest by American College of Chest Physicians and Society of Critical Care Medicine in 1992, researches on burn sepsis have focused on the regulation of immune-inflammation response resulting in minimizing tissue injury resulted from excessive inflammatory response. Treatment of sepsis should focus on effect of early circulation oxygenation support in preventing and treating multiple organ dysfunction. The hypothesis of producing a hibernation-like state which might prevent multiple organ dysfunction in patients with sepsis provides us a new therapeutic strategy in protecting organs in the early stage of sepsis in future.
Burns ; complications ; therapy ; Humans ; Sepsis ; diagnosis ; etiology ; therapy

Salmonella infection can cause an asymptomatic intestinal carrier state or clinical diseases such as enterocolitis presenting abdominal pain, fever, vomiting, or diarrhea. Salmonella usually invades Peyer's patch of terminal ileum or ascending colon. Sepsis is not common and acute renal failure secondary to rhabdomyolysis is rare. The causes of rhabdomyolysis are trauma, excessive exercise, alcohol, seizure, metabolic abnormality, and infection. Infections account for less than 5% of the reported causes of rhabdomyolysis and resulting acute renal failure. The mechanisms underlying rhabdomyolysis due to infection are direct muscle invasion, toxin production, and nonspecific effects that can occur with infections such as fever, dehydration, acidosis, and electrolyte imbalance. We report a case of sepsis and acute renal failure secondary to rhabdomyolysis associated with Salmonella infection.
Colonoscopy ; Enterocolitis/complications/*diagnosis ; Humans ; Kidney Failure, Acute/*diagnosis/etiology ; Male ; Middle Aged ; Rhabdomyolysis/diagnosis/etiology/microbiology ; Salmonella Infections/complications/*diagnosis ; Sepsis/*diagnosis/etiology ; Tomography, X-Ray Computed

Burns ; complications ; diagnosis ; prevention & control ; Humans ; Sepsis ; diagnosis ; etiology ; prevention & control

OBJECTIVETo investigate and re-evaluate the relationship between burn wound sepsis and tissue bacterial quantity.

METHODSThirty-two patients admitted during past 5 years were enrolled in the study. Bacterial isolation and quantity in burn wound tissue were carried out. Meanwhile clinical signs were evaluated for the staging of burn wound sepsis.

RESULTS1) Bacterial invasion could be identified in 123 pieces of tissue samples from 32 patients. Samples with tissue bacterial quantity > or = 10(5)/g were found in 82 subeschar tissue samples, and 41 samples with bacteria <10(5)/g. Subeschar tissue samples with bacterial quantity > or = 10(5)/g could be determined in 68 samples from 18 patients, and < 10(5)/g in 20 samples from 5 cases. In addition, samples of subeschar tissue with bacterial quantity > or = 10(5)/g could only be found in some of the samples form 9 cases. 2) Burn wound sepsis could be classified into I-IV stages according to tissue bacterial quantification and clinical signs.

CONCLUSIONBurn wound sepsis could be established by identification of bacterial invasion into living tissue with clinical symptoms of toxemia.

Adolescent ; Adult ; Burns ; complications ; diagnosis ; microbiology ; Colony Count, Microbial ; Female ; Humans ; Male ; Middle Aged ; Sepsis ; diagnosis ; etiology ; microbiology ; Young Adult

Acute-on-chronic liver failure (ACLF) is an increasingly recognized distinct disease entity encompassing an acute deterioration of liver function in patients with chronic liver disease. Although there are no widely accepted diagnostic criteria for ACLF, the Asia.Pacific Association for the Study of the Liver (APASL) and the American Association for the Study of Liver Disease and the European Association for the Study of the Liver (AASLD/EASL) consensus definitions are commonly used. It is obvious that the APASL and the AASLD/EASL definitions are based on fundamentally different features. Two different definitions in two different parts of the world hamper the comparability of studies. Recently, the EASL-Chronic Liver Failure Consortium proposed new diagnostic criteria for ACLF based on analyses of patients with organ failure. There are areas of uncertainty in defining ACLF, such as heterogeneity of ACLF, ambiguity in qualifying underlying liver disease, argument for infection or sepsis as a precipitating event, etc. Although the exact pathogenesis of ACLF remains to be elucidated, alteration of host response to injury, infection, and unregulated inflammation play important roles. The predisposition, infection/inflammation, response, organ failure (PIRO) concept used for sepsis might be useful in describing the pathophysiology and clinical categories for ACLF. Treatment strategies are limited to organ support but better understanding of the pathophysiology is likely to lead to discovery of novel biomarkers and therapeutic strategies in the future.
Chronic Disease ; Echocardiography ; Humans ; Liver Cirrhosis/complications ; Liver Failure/diagnosis/etiology/*pathology/prevention & control ; Liver Failure, Acute/diagnosis/etiology/*pathology/prevention & control ; Liver Transplantation ; Sepsis/complications

Enbucrilate ; adverse effects ; therapeutic use ; Female ; Humans ; Hypertension, Portal ; diagnosis ; etiology ; Liver Cirrhosis, Biliary ; drug therapy ; Middle Aged ; Pulmonary Embolism ; chemically induced ; diagnosis ; Sepsis ; chemically induced ; etiology

Animals ; Anticonvulsants ; adverse effects ; Cattle ; Drug Hypersensitivity ; complications ; diagnosis ; etiology ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; Middle Aged ; Sepsis ; diagnosis ; Syndrome ; Triazines ; adverse effects ; Zoonoses ; etiology

Diarrhea, Infantile ; etiology ; Escherichia coli ; isolation & purification ; Escherichia coli Infections ; complications ; diagnosis ; Female ; Fever ; diagnosis ; Humans ; Infant, Newborn ; Male ; Meningitis, Escherichia coli ; etiology ; Prognosis ; Sepsis ; complications ; diagnosis ; etiology ; Treatment Outcome