Diagnosis of sepsis associated encephalopathy:a retrospective analysis of 6 patients / 中国基层医药

ABSTRACT

Objective To investigate whether the presence of infection in a case series with coma would predict sepsis associated encephalopathy(SAE).Methods From Jan 2013 to Oct 2014,we used the criteria of systemic inflammatory response syndrome (SIRS)positive sepsis with encephalopathy and retrospective diagnosed a comatose case series with infection and from a tertiary teaching hospital intensive care unit (ICU).Results Among 6 comatose patients with evidence of infection,3 cases were secondary infection after hemorrhagic stroke,1 case was secondary infection after trauma,and the other 2 cases were primary infection.All patients met the diagnosis of SIRS -positive sepsis with encephalopathy.Among them,the presence of SIRS 3 criteria was in 2 cases,four criteria in 4 cases. All patients with severe brain failure (100%),in addition to 5 cases with acute respiratory failure caused by lung injury,one case with acute liver failure.Brain imaging confirmed that the delayed vasogenic edema was in two cases (33.3%),the cerebral ischemic lesions in four cases(66.7%).The ischemic lesion included 1 patient with minor infarcts and 1 case with mild white matter lesions,and with a good prognosis.The other two ischemic cases included multifocal leukoencephalopathy with central pontine myelinolysis in 1 case and extensive white matter lesions in 1 case,eventually with a poor prognosis.Conclusion SAE is a common critically illness,the use of the new classifi-cation criteria of sepsis is helpful in the diagnosis of sepsis associated encephalopathy.