Subtypes and Mimics of Sepsis

John A Kellum; Cassandra L Formeck; Kate F Kernan; Hernando Gómez; Joseph A Carcillo

doi:10.1016/j.ccc.2021.11.013

Subtypes and Mimics of Sepsis

Crit Care Clin. 2022 Apr;38(2):195-211. doi: 10.1016/j.ccc.2021.11.013.

Authors

John A Kellum¹, Cassandra L Formeck², Kate F Kernan³, Hernando Gómez⁴, Joseph A Carcillo³

Affiliations

¹ Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. Electronic address: [email protected].
² Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA.
³ Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA.
⁴ Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.

PMID: 35369943
DOI: 10.1016/j.ccc.2021.11.013

Abstract

Sepsis is a heterogenous and imprecise syndrome that includes multiple phenotypes, some of which are amenable to specific therapies. Developing new therapies for sepsis will require focusing on subsets of patients. Key to improving care is evaluating patients for sepsis mimics and treatable diseases whose manifestations lead to a clinical classification of sepsis. Because sepsis is common, it is easy to overlook unusual causes of organ failure and succumb to confirmation bias about the nature of an illness. Careful attention to medical and family histories, focused diagnostic testing, and subspecialty input can help identify potentially treatable diseases masquerading as typical sepsis.

Keywords: Atypical hemolytic uremic syndrome; Blood purification; Endotoxemia; Endotoxin; Macrophage activation syndrome; Polymyxin B.

Publication types

Review

MeSH terms

Humans
Sepsis* / diagnosis
Sepsis* / therapy

Grants and funding

R01 GM108618/GM/NIGMS NIH HHS/United States