[Leukemoid reaction with uncommonly high leucocytosis in the course of serious infection]. / Odczyn bialaczkowy z niespotykanie wysoka leuko- cytoza w przebiegu ciezkiego zakazenia.

We present a case of 51-year old female patient with gastrointestinal perforation and septic shock leading to leukemoid reaction with WBC 155 x 109/l. Leukemoid reaction in neoplasms and infections can mimic chronic myelogenous leukaemia and is an important diagnostic problem.

Severe sepsis in Poland--results of internet surveillance of 1043 cases.

BACKGROUND: Severe sepsis is a clinical syndrome frequently occurring in intensive care units (ICUs) when systemic infection results in multiorgan dysfunction. No Polish data concerning treatment and prognosis in this group of patients have been available to date. MATERIAL/METHODS: The Polish Working Group for Sepsis introduced in 2003 internet registration of severe sepsis cases treated in ICUs in Poland. Information about severe sepsis were entered including the type of infection, clinical course, methods and results of treatment. RESULTS: From 20.04.2003 to 10.01.2004, 1043 severe sepsis cases were reported by 104 ICUs. Mean age of patients was 59 years. Mean duration of treatment was 19 days, with mortality rate of 55%. In 60% dysfunction of 4 or more organs was diagnosed. In 55% the underlying disease was surgical and abdominal cavity was the primary infection site (47%). Pathogens most likely to cause severe sepsis were G- (48%) and G+ (43%) bacteria, as well as fungi (21%). Positive blood culture was obtained in 45% of patients. Treatment involved antibiotic and support of organ function. Activated protein C was used in 8.2%, causing a reduction of mortality. CONCLUSIONS: Severe sepsis in Polish ICUs develops most frequently in the course of intra-abdominal infections. Dysfunction of 4 or more organs caused observed high mortality (55%) Internet surveillance proved to be useful method of collecting information, widely accepted by personnel of ICUs.