Bacteremia and Sepsis

  • James M. Herman
  • William J. Curry
  • Edward G. Paul


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


Septic Shock Severe Sepsis Systemic Inflammatory Response Syndrome Lactic Acidosis Endothelial Damage 


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Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • James M. Herman
  • William J. Curry
  • Edward G. Paul

There are no affiliations available

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