Which physical signs suggest focal and bacterial infection in patients with multiple organ dysfunction syndrome (MODS) in sepsis?

Updated: Jan 27, 2020
  • Author: Ali H Al-Khafaji, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

The following physical signs suggest focal, usually bacterial, infection:

  • Central nervous system (CNS) infection - Profound depression in mental status and meningismus

  • Head and neck infections - Inflamed or swollen tympanic membranes, sinus tenderness, pharyngeal exudates, stridor, cervical lymphadenopathy

  • Chest and pulmonary infections - Localized rales or evidence of consolidation

  • Cardiac infections - Regurgitant valvular murmur

  • Abdominal and GI infections - Focal tenderness, guarding or rebound, rectal tenderness, or swelling

  • Pelvic and GU infections - Costovertebral angle tenderness, pelvic tenderness, cervical motion pain, and adnexal tenderness

  • Bone and soft tissue infections - Focal erythema, edema, infusion, and tenderness

  • Skin infections - Petechiae and purpura


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