Abstract
Sepsis occurs both community acquired and as a complication of hospital treatment.
The symptoms are usually nonspecific and there is no diagnostic gold standard. The
diagnostic
differentiation from other clinical pictures is difficult. Therefore, the (early)
diagnosis of sepsis is still a major challenge for the clinician. Despite multiple
biomarkers described in
the scientific literature sepsis is still primarily a clinical diagnosis. qSOFA can
be a helpful screening tool.
Finding and treating the focus of infection is a crucial part of sepsis therapy. Chest
X-ray and sonography have limited sensitivity for this purpose. A CT-scan with contrast
should be done
at least in all patients where the focus of infection is still unclear. An MRI is
necessary if spondylodiscitis is suspected, a transesophageal echocardiography if
endocarditis is a possible
focus. Biomarkers are helpful in guiding therapy but are not part of the initial diagnosis
criteria. Blood cultures and microbiological samples from the suspected foci of infection
should be
taken in all sepsis patients. An initial lactate measurement is also part of the diagnostic
workup and necessary for the diagnosis of septic shock.
Sepsis tritt sowohl ambulant erworben als auch als Komplikation einer Krankenhausbehandlung
auf. Die Symptomatik ist meist unspezifisch, und es fehlt ein diagnostischer Goldstandard.
Die
differenzialdiagnostische Abgrenzung zu anderen Krankheitsbildern ist schwierig. Deshalb
ist die (frühzeitige) Diagnose der Sepsis immer noch eine große Herausforderung für
den Kliniker.
Schlüsselwörter
Sepsis - Diagnostik - Symptome - Blutkulturen - Infektionsfokus
