Sepsis differential diagnosis

Resident Survival Guide

Sepsis Microchapters
Home
Patient Information (Adult)
Patient Information (Neonatal)
Overview
Pathophysiology
Causes
Differentiating Sepsis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Sepsis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sepsis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sepsis differential diagnosis
CDC on Sepsis differential diagnosis
Sepsis differential diagnosis in the news
Blogs on Sepsis differential diagnosis
Directions to Hospitals Treating Sepsis
Risk calculators and risk factors for Sepsis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Sepsis must be differentiated from other syndromes such as the acute bacterial endocarditis, myocardial ring abscess, subacute bacterial endocarditis and bacterial meningitis.

Differential Diagnosis

Sepsis must be differentiated from other causes of shock and fever based on clinical and hemodynamic findings.

Classification of shock based on hemodynamic parameters.

Type of Shock	Etiology	CO	SVR	PCWP	CVP	SVO2	RVS	RVD	PAS	PAD
Cardiogenic	Acute Ventricular Septal Defect	↓↓	↑	N — ↑	↑↑	↑ — ↑↑	N — ↑	↑	N — ↑	N — ↑
	Acute Mitral Regurgitation	↓↓	↑	↑↑	↑ — ↑↑	↓	↑	N — ↑	↑	↑
	Myocardial Dysfunction	↓↓	↑	↑↑	↑↑	↓	N — ↑	N — ↑	N — ↑	↑
	Right Ventricular Infarction	↓↓	↑	N — ↓	↑↑	↓	↓ — ↑	↑	↓ — ↑	↓ — ↑
Obstructive	Pulmonary Embolism	↓↓	↑	N — ↓	↑↑	↓	↓ — ↑	↑	↓ — ↑	↓ — ↑
	Cardiac Tamponade	↓ — ↓↓	↑	↑↑	↑↑	↓	N — ↑	↑	N — ↑	N — ↑
Distributive	Septic Shock	N — ↑↑	↓ — ↓↓	N — ↓	N — ↓	↑ — ↑↑	N — ↓	N — ↓	↓	↓
	Anaphylactic Shock	N — ↑↑	↓ — ↓↓	N — ↓	N — ↓	↑ — ↑↑	N — ↓	N — ↓	↓	↓
Hypovolemic	Volume Depletion	↓↓	↑	↓↓	↓↓	↓	N — ↓	N — ↓	↓	↓

Abbreviations: CO: cardiac output, CVP: central venous pressure, PAD: pulmonary artery diastolic pressure. PAS: pulmonary artery systolic pressure, RVD: right ventricular diastolic pressure.RVS: right ventricular systolic pressure. SVO2: systemic venous oxygen saturation, SVR: systemic vascular resistance.

Other non-infectious causes of systemic inflammatory response syndrome (SIRS) that must be considered include:

• Postoperative recovery
• Penetrating trauma
• Burns
• Transplant rejection
• Hyperthyroidism
• Addisonian crisis
• Blood product transfusion reactions
• Serum sickness
• Immunizations
• CNS infarction or hemorrhages
• Leukemia
• Malignant hyperthermia
• Neuroleptic malignant syndrome
• Serotonergic syndrome
• Delirium tremens
• Metformin lactic acidosis