title: Sepsis: a review for the neurohospitalist.
abstract: Sepsis represents a major challenge in medicine. It begins as a systemic response to infection that can affect virtually any organ system, including the central and peripheral nervous systems. Akin to management of stroke, early recognition and treatment of sepsis are just as crucial to a successful outcome. Sepsis can precipitate myasthenic crisis and lead to encephalopathy and critical illness neuropathy. Stroke and traumatic brain injury can predispose a patient to develop sepsis, whereas Guillain-Barré syndrome is similarly not uncommon following infection. This review article will first describe the essential principles of sepsis recognition, pathophysiology, and management and will then briefly cover the neurologic aspects associated with sepsis. Vigilant awareness of the clinical features of sepsis and timeliness of intervention can help clinicians prevent progression of this disease to a multisystem organ failure, which can be difficult to reverse even after the original source of infection is under control.
authors: Division of Pulmonary Medicine, Department of Critical Care, Mayo Clinic, Jacksonville, FL, USA.
authors: Lioudmila V
authors: LV
authors: Karnatovskaia
authors: Emir
authors: E
authors: Festic
keywords: neurocritical care; sepsis; septic shock
references: Crit Care Med. 2001 Jul;29(7):1303-10
references: 11445675
references: J Antimicrob Chemother. 2010 Feb;65(2):342-6
references: 20008043
references: Muscle Nerve. 2005 Aug;32(2):140-63
references: 15825186
references: Curr Opin Microbiol. 1998 Feb;1(1):49-55
references: 10066457
references: Crit Care Med. 2009 Oct;37(10 Suppl):S331-6
references: 20046118
references: Biomarkers. 2011 Jul;16 Suppl 1:S11-21
references: 21707440
references: Ann Intern Med. 1996 Oct 15;125(8):680-7
references: 8849154
references: JAMA. 2010 Oct 27;304(16):1787-94
references: 20978258
references: N Engl J Med. 2001 Nov 8;345(19):1368-77
references: 11794169
references: NCHS Data Brief. 2011 Jun;(62):1-8
references: 22142805
references: Shock. 2007 Mar;27(3):281-8
references: 17304109
references: N Engl J Med. 2004 May 27;350(22):2247-56
references: 15163774
references: N Engl J Med. 2000 May 4;342(18):1301-8
references: 10793162
references: JAMA. 2010 Feb 24;303(8):739-46
references: 20179283
references: N Engl J Med. 2008 Jan 10;358(2):111-24
references: 18184957
references: Nat Rev Neurosci. 2005 Oct;6(10):775-86
references: 16163382
references: Crit Care Clin. 2011 Jan;27(1):53-76
references: 21144986
references: N Engl J Med. 2008 Jan 10;358(2):125-39
references: 18184958
references: Crit Care. 2010;14(3):R102
references: 20525247
references: Intensive Care Med. 2009 Jan;35(1):63-8
references: 18946661
references: Clin Infect Dis. 2006 Jul 1;43(1):25-31
references: 16758414
references: Crit Care Med. 2011 Aug;39(8):1859-65
references: 21499086
references: Stroke. 2007 Feb;38(2 Suppl):770-3
references: 17261736
references: Chest. 2011 Nov;140(5):1216-1222
references: 21816912
references: Crit Care Med. 2003 Apr;31(4):1250-6
references: 12682500
references: J Trauma. 2011 Nov;71(5):1226-34
references: 22071924
references: N Engl J Med. 2002 Mar 28;346(13):1025-6; author reply 1025-6
references: 11919315
references: Intensive Care Med. 2011 Sep;37(9):1432-7
references: 21779849
references: Neurol Res. 2007 Oct;29(7):643-6
references: 18173900
references: Crit Care. 2011 Aug 11;15(4):226
references: 21892977
references: J Intensive Care Med. 2012 May-Jun;27(3):172-8
references: 21436167
references: N Engl J Med. 2001 Nov 8;345(19):1359-67
references: 11794168
references: J Neurosurg. 2001 May;94(5):706-11
references: 11354400
references: Semin Neurol. 2004 Mar;24(1):75-81
references: 15229794
references: J Neurol. 2001 Nov;248(11):929-34
references: 11757954
references: JAMA. 2011 Nov 23;306(20):2248-54
references: 22081378
references: Natl Vital Stat Rep. 2011 Mar;59(4):1-51
references: 25073815
references: Clinics (Sao Paulo). 2011;66(10):1825-31
references: 22012058
references: Crit Care. 2010;14(2):R40
references: 20298543
references: PLoS One. 2011;6(12):e29749
references: 22216353
references: Lancet Neurol. 2011 Oct;10(10):931-41
references: 21939902
references: J Crit Care. 2012 Apr;27(2):153-8
references: 21855283
references: Am J Respir Crit Care Med. 2006 Feb 1;173(3):256-63
references: 16239619
references: Infection. 2011 Aug;39(4):309-18
references: 21594653
references: Chest. 1992 Jun;101(6):1644-55
references: 1303622
references: JAMA. 2002 Aug 21;288(7):862-71
references: 12186604
references: N Engl J Med. 2003 Apr 17;348(16):1546-54
references: 12700374
references: N Engl J Med. 2009 Mar 26;360(13):1283-97
references: 19318384
references: Langenbecks Arch Surg. 2010 Jun;395(5):489-94
references: 20517699
references: Crit Care Med. 2006 Jun;34(6):1589-96
references: 16625125
references: Shock. 2010 Apr;33(4):344-52
references: 19789465
references: Crit Care Med. 2009 May;37(5):1594-603
references: 19325471
references: Respir Care. 2006 Sep;51(9):1024-40; discussion 1040-1
references: 16934166
references: Intensive Care Med. 2006 Dec;32(12):2077
references: 17131165
references: JAMA. 2009 Jun 10;301(22):2362-75
references: 19509383
references: Intensive Care Med. 2004 Jun;30(6):1032-40
references: 15148567
references: Chest. 2011 Nov;140(5):1223-1231
references: 21852297
references: Crit Care Med. 2004 Mar;32(3):858-73
references: 15090974
references: N Engl J Med. 2010 Sep 16;363(12):1107-16
references: 20843245
references: N Engl J Med. 2010 Mar 4;362(9):779-89
references: 20200382
references: JAMA. 2011 Dec 21;306(23):2594-605
references: 22187279
references: Circulation. 2006 Feb 14;113(6):e85-151
references: 16407573
references: Crit Care Med. 2008 Jan;36(1):296-327
references: 18158437
references: Intensive Care Med. 2009 Nov;35(11):1868-76
references: 19652948
references: BMC Emerg Med. 2008 Jan 24;8:1
references: 18218122
references: N Engl J Med. 2008 Feb 28;358(9):877-87
references: 18305265
references: Crit Care. 2012 Dec 12;16(2):R44
references: 22410278
references: Regul Pept. 2008 Apr 10;147(1-3):67-71
references: 18243366
references: Neurology. 2008 Apr 29;70(18):1608-13
references: 18443311
references: N Engl J Med. 1999 Feb 11;340(6):409-17
references: 9971864
references: Crit Care. 2011;15(6):R290
references: 22136422
references: Crit Care Med. 2002 May;30(5 Suppl):S294-301
references: 12004251
references: Shock. 2011 Apr;35(4):355-9
references: 21192282