Sepsis should be suspected in patients with fever and hypotension plus which of the following injuries? (Exception listed)

Sepsis should be suspected in patients with fever and hypotension plus which of the following injuries? (Exception listed)

• A. Thoracic spinal deformity
• B. Abdominal trauma
• C. Chest injury
• D. Open fracture

Answer: (A)

Sepsis in a feverish, hypotensive trauma patient is most likely from an infection source directly related to the injury. Abdominal trauma can lead to hollow-viscera perforation and intra-abdominal infection, which can quickly cause sepsis. Chest injuries can result in pneumonia, empyema, or infected contusions, all of which can drive septic processes. Open fractures carry a high risk of contamination and subsequent osteomyelitis or septicemia. In contrast, a thoracic spinal deformity is not an acute injury that creates a primary infectious source in this setting; by itself it does not predispose to sepsis in the same way as the others. Therefore, fever and hypotension plus an injury pattern involving potential infectious sources point toward those injuries, with the deformity being the exception.

Sepsis in a feverish, hypotensive trauma patient is most likely from an infection source directly related to the injury. Abdominal trauma can lead to hollow-viscera perforation and intra-abdominal infection, which can quickly cause sepsis. Chest injuries can result in pneumonia, empyema, or infected contusions, all of which can drive septic processes. Open fractures carry a high risk of contamination and subsequent osteomyelitis or septicemia. In contrast, a thoracic spinal deformity is not an acute injury that creates a primary infectious source in this setting; by itself it does not predispose to sepsis in the same way as the others. Therefore, fever and hypotension plus an injury pattern involving potential infectious sources point toward those injuries, with the deformity being the exception.