Chapter 271

### Definitions

(See Table 271-1) Animals mount both local and systemic responses to microbes that traverse their epithelial barriers and enter underlying tissues. Fever or hypothermia, leukocytosis or leukopenia, tachypnea, and tachycardia are the cardinal signs of the systemic response, that is often called the systemic inflammatory response syndrome (SIRS). SIRS may have an infectious or a noninfectious etiology. If infection is suspected or proven, a patient with SIRS is said to have sepsis. When sepsis is associated with dysfunction of organs distant from the site of infection, the patient has severe sepsis. Severe sepsis may be accompanied by hypotension or evidence of hypoperfusion. When hypotension cannot be corrected by infusing fluids, the diagnosis is septic shock. These definitions were developed by consensus conference committees in 1992 and 2001 and have been widely used; there is evidence that the different stages may form a continuum.

Table 271–1. Definitions Used to Describe the Condition of Septic Patients

### Etiology

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