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Friday, 29 November 2013

Thyroid Disease : Euthyroid sick syndrome as a result of Sepsis - The Symptoms

 Sepsis is defined as a condition caused by chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body as a result of severe infection(a)(b). according to the study by the University of Utah, sepsis is the commonest cause of admission to medical ICUs across the world. Mortality from sepsis continues to be high. Besides shock and multi-organ dysfunction occurring following the intense inflammatory reaction to sepsis, complications arising from sepsis-related immunoparalysis contribute to the morbidity and mortality from sepsis(c).


A. Symptoms
1. Chilly periphery, fever, jaundice, platelet and hemoglobin
I(n the study to o explore the risk factors, clinical symptoms, hematological parameters, causative pathogen and antibiotic susceptibility of neonatal sepsis in a Chinese NICU, found that the clinical symptoms or laboratory results such as chilly periphery, fever, jaundice, platelet and hemoglobin also had between-group differences. The most common responsible pathogenic bacteria species present in EOS group was Coagulase-negative Staphylococcus (CoNS)(1).

2. Abnormalities of blood pressure, respiration, temperature, and heart rate, and less well-known changes in heart rate variability
Early detection of late-onset neonatal sepsis, before the onset of obvious and potentially catastrophic clinical signs, is an important goal in neonatal medicine. Sepsis causes a well-known series of physiologic changes including abnormalities of blood pressure, respiration, temperature, and heart rate, and less well-known changes in heart rate variability, according to the University of Virginia(2).

3. Significantly decreased urine output but accumulative fluid balance had a weak correlation with delta sequential organ failure assessment score (r = 0.32, P = 0.001) and lung injury score (r = 0.13, P = 0.02) and negative correlation with PaO2/FIO2 ratio (r = -0.28, P = 0.001)(3).

4. Abrupt change in mental status, difficult breathing and abnormal blood circulation
Early recognition of sepsis and septic shock in children relies on obtaining an attentive clinical history, accurate vital signs, and a physical examination focused on mental status, work of breathing, and circulatory status, according to the study by the University of Colorado School of Medicine(4).

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Sources
(a) http://en.wikipedia.org/wiki/Sepsis
(b) http://www.mayoclinic.com/health/sepsis/DS01004 
(c) http://www.ncbi.nlm.nih.gov/pubmed/24082613
(1) http://www.ncbi.nlm.nih.gov/pubmed/24040479
(2) http://www.ncbi.nlm.nih.gov/pubmed/20813272
(3) http://www.ncbi.nlm.nih.gov/pubmed/23635850 
(4) http://www.ncbi.nlm.nih.gov/pubmed/23915595