Which studies are included in the workup of bacterial sepsis?

Updated: Feb 05, 2019
  • Author: Amber Mahmood Bokhari, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Multiple clinical, laboratory, radiologic, and microbiologic data are required for the diagnosis of sepsis and septic shock. Sepsis should never be diagnosed based on a single abnormality. However, the diagnosis is often made empirically at the bedside upon presentation or retrospectively when follow-up data return (eg, positive blood culture result) or a response to antibiotics is evident. Importantly, the identification of a pathogenic organism, although preferred, is not always feasible since the responsible organism may be unidentified in many patients.

In general, the workup for sepsis may include the following:

  • Blood culture and urine analysis and culture
  • Chemistry studies that can suggest organ dysfunction, such as liver or kidney function tests
  • Chest radiology
  • Diagnostic imaging of the chest and abdomen/pelvis
  • Cardiac studies such as ECG and troponins, as indicated
  • Interventions such as paracentesis, thoracentesis, lumbar puncture, or aspiration of an abscess, as clinically indicated
  • Measurement of biomarkers of sepsis such as procalcitonin levels

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