Clinical Mimics: An Emergency Medicine–Focused Review of Sepsis Mimics

Brit Long, MD; Alex Koyfman, MD


J Emerg Med. 2017;52(1):34-42. 

In This Article


SIRS and sepsis exist along a continuum resulting from uncontrolled systemic response. There are many mimics for sepsis. The most important aspect of managing these patients is resuscitation first. Obtaining rapid IV access, monitor placement, and supplemental oxygen while evaluating the ABCDE's (i.e., airway, breathing, circulation, disability, and exposure/examination) are essential in resuscitation. The history and examination are keys to diagnosis, but sepsis must always be considered. Sepsis requires a suspected source of infection. If no source is found, reassess the differential and consider anaphylaxis, aspiration, bowel obstruction, colitis, hypovolemia, pancreatitis, pulmonary embolism, gastrointestinal bleeding, toxic overdose, medication effect, and vasculitis, among others. Continual reevaluation of the patient for treatment response may assist in decreasing morbidity and mortality.