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Wednesday, 22 May 2019 23:26

Sepsis is NOT a single disease but has subtypes

Written by Dr. Daliah Wachs
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One of the leading causes of death in hospitalized patients is much more complex than once thought.

Septicemia is an infection that enters one’s blood stream.  This can result in Sepsis, a life threatening condition that occurs in response to the blood infection. Its definition has been fluid over the years as more research reveals it’s a disease process.

Sepsis-Awareness-web

IMAGE FROM TRISTATEHOSPITAL.ORG

Now researchers in a study published in JAMA describe 4 separate subtypes of Sepsis. These include:

α phenotype had fewer abnormal laboratory values and less organ dysfunction;

those with the β phenotype were older, had greater chronic illness, and were more likely to present with renal dysfunction;

those with the γ phenotype were more likely to have elevated measures of inflammation (eg, white blood cell count, premature neutrophil count [bands], erythrocyte sedimentation rate, or C-reactive protein), lower albumin level, and higher temperature; and those with the δ phenotype had elevated serum lactate levels, elevated levels of transaminases, and hypotension

Dr. Christopher Seymour of the University of Pittsburgh School of Medicine, states in Medical Express, “Right now, our treatment approach to sepsis is basically ‘one size fits all,’ whether you are a 40-year-old with influenza complicated by [a] staff infection or an 80-year-old with multiple comorbidities and biliary sepsis,” he said, adding that international sepsis practice guidelines recommend the same bundle of care for everyone.”

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Current goals in medicine aim to treat the patient rather than the disease, and as we need to individualize treatment for those with high blood pressure, cancer and diabetes, we need to as well with acute, deadly diseases such as sepsis.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.