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a severe infectious disease affecting man and animals caused by the entry of pyogenic microorganisms and their toxins into the blood and tissues. The causative agents of sepsis are most often streptococci and staphylococci; less common causative agents are pneumococci, colon bacillus, and other microorganisms.
Sepsis is usually a complication of a wound or an inflammatory process. A weakening in the body’s defense mechanisms as a result of a serious illness, surgery, a severe loss of blood, or poor nutrition may lead to the development of the disease in humans. The source of surgical sepsis may be a suppurative wound or the complicated course of local purulent diseases, including furuncles, carbuncles, and phlegmons. Complications after childbirth or abortion may lead to puerperal sepsis, when infection enters the body through the uterine mucosa. Purulent processes or damage to the organs of the urogenital system and urinary engorgement and infection may result in urosepsis, and acute or chronic purulent diseases of the organs of the oral cavity may lead to oral sepsis.
Sepsis is manifested by local symptoms at the primary focus of the disease; for example, the cleansing of a wound and the growth of granulations in the wound cease, and the granulations appear pale and dry, with a turbid coating. The general symptoms include headache and, in serious cases, mental confusion, a body temperature reaching 39–40°C with large daily fluctuations, progressive emaciation, an increase in the pulse rate, a decrease in arterial pressure, and the development of thromboses, edemas, and decubital ulcers. The clinical course of sepsis may be immediate (with severe manifestations developing within one or two days), acute (with symptoms developing in five to seven days), subacute, or chronic. The disease often proceeds atypically and its symptoms disappear because of substantial changes in the pathogenic properties of the causative agents resulting from the massive use of antibiotics. For example, at the height of the disease an individual may not have a high temperature.
Sepsis may proceed with the formation of local abscesses originating from the primary focus in various organs and tissues—a condition called septicopyemia. During septicopyemia the course of sepsis depends on the distribution of the abscesses, for example, an abscess can be located in the brain, causing neurological disturbances. Sepsis may also proceed without metastatic abscesses—a condition called septicemia. Septicemia is often more severe in its course and general symptoms than septicopyemia. Umbilical sepsis, which develops in the newborn, originates from a purulent process in the tissues and vessels of the umbilical cord. It is characterized by vomiting, diarrhea, the child’s complete refusal of the breast, rapid emaciation, and dehydration. The skin loses its elasticity, becomes dry, and acquires an earthy color. Frequently, there is local suppuration around the navel, and deep phlegmons and abscesses develop in other areas. The manifestations of sepsis in animals are basically the same as those in humans.
The treatment of sepsis is directed toward controlling the infection with sulfanilamide preparations and large doses of antibiotics. The dosage of antibiotics is determined by the sensitivity of the causative agent. The body’s resistance is strengthened with vitaminized high-calorie nutrition, blood transfusion, infusion of protein preparations, and the use of specific serums, autovaccines, and gamma globulin. Local treatment when there are wounds includes the timely removal of necrosed tissues and opening of purulent swellings, the constant drainage of purulent discharge, and the administration of antibiotics and antiseptics.
REFERENCESShlapoberskii, V. Ia. Khirurgicheskii sepsis: Klinika i lechenie. Moscow, 1952.
Skvortsov, M. A. “Pupochnyi sepsis.” In Mnogotomnoe rukovodstvo po patologicheskoi anatomii, vol. 3. Moscow, 1960.
Bublichenko, L. I., and S. G. Khaskin. “Poslerodovye infektsionnye zabolevaniia.” In Mnogotomnoe rukovodstvo po akusherstvu i ginekologii, vol. 3, book 2. Moscow, 1964.
V. F. POZHARISKII