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2014 ; 2014
(ä): 762320
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Sepsis Associated Encephalopathy
#MMPMID26556425
Chaudhry N
; Duggal AK
Adv Med
2014[]; 2014
(ä): 762320
PMID26556425
show ga
Sepsis associated encephalopathy (SAE) is a common but poorly understood
neurological complication of sepsis. It is characterized by diffuse brain
dysfunction secondary to infection elsewhere in the body without overt CNS
infection. The pathophysiology of SAE is complex and multifactorial including a
number of intertwined mechanisms such as vascular damage, endothelial activation,
breakdown of the blood brain barrier, altered brain signaling, brain
inflammation, and apoptosis. Clinical presentation of SAE may range from mild
symptoms such as malaise and concentration deficits to deep coma. The evaluation
of cognitive dysfunction is made difficult by the absence of any specific
investigations or biomarkers and the common use of sedation in critically ill
patients. SAE thus remains diagnosis of exclusion which can only be made after
ruling out other causes of altered mentation in a febrile, critically ill patient
by appropriate investigations. In spite of high mortality rate, management of SAE
is limited to treatment of the underlying infection and symptomatic treatment for
delirium and seizures. It is important to be aware of this condition because SAE
may present in early stages of sepsis, even before the diagnostic criteria for
sepsis can be met. This review discusses the diagnostic approach to patients with
SAE along with its epidemiology, pathophysiology, clinical presentation, and
differential diagnosis.