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Vitae
Name : Tatar Sumandjar
Institution : Medical Staff Division Tropical
Medicine and
Infectious Diseases, Dept. of
Internal Medicine
Medical Faculty University of
Sebelas Maret/
Dr. Moewardi Hospital, Surakarta
Graduates:
MD : FK UGM : 1983
Internist : FK UGM : 2000
Consultant : FK UI : 2008
Occupation:
Puskesmas in Purworejo, Central Java 1984 -
1990
SEPSIS OF
UNKNOWN SOURCE
Tatar Sumandjar
Division of Tropical medicine and Infectious Disease,
Department of Internal Medicine
Faculty of Medicine
University of Sebelas Maret
Surakarta
INTRODUCTION
Immunosuppressed patients were younger and
more likely to have underlying liver or lung
disease, and nosocomial infection or bloodstream
infection of unknown source when presenting with
sepsis.
Sepsis among patients immunosuppressed prior
to the onset of sepsis was associated with higher
mortality than in immunocompetent
Poutsiaka, patients.
D D, 2009; Scandinavian Journal
of Infectious Diseases
Genetic Susceptibility
Predispositio R
Resistance to Antimicrobial
Coexisting health complications
n U
T Pathogen, toxicity and immunity
Infection N Location and compartmentalization
Dysfunction
Optimum Individualized Treatment
bacterial Cardiac surgery
Asphyxia/Hypoxia
viral sepsis Systemic
inflammatory
fungal response Trauma and burns
(SIRS)
parasital Neonatal lung
Severe affectionS
sepsis or SIRS
others shock Others
(Bone,1992)
Infective cause Noninfective cause
ROLE OF CYTOKINES
IL1,TNFa, IL6, IL8, IL-10
netrofil
ENDOTHEL (Guntur 2000)
The Third International
Consensus Definitions for Sepsis
and Septic Shock (Sepsis-3),
2016
Sepsis is defined as life-threatening organ dysfunction due to
dysregulated host response to infection
Data collected over an 8-year period from 22 hospitals (Annane et al Am J Respir Crit Care Med
2003; 168:165-72)
2
3 Source of
Septic Shock
E. Coli sp 4 4
Enterobacter sp 25 9 10 8
Klebsiella sp 5 1 15 7
Gr - 59 25 31 22
Proteus sp 9 57.28% 32.05% 3 23.30% 1 30.13%
Pseudomonas sp 16 4 3 2
Salmonella sp 4
Serratia sp 1
Staphylococcus sp 16 20 7 20 7 30 8 10
Gr +
Streptococcus sp 4 42.72% 13 67.95% 23 76.70% 2 69.87%
(Guntur, 2005)
Blood Culture and Sensitibility (RSDM Solo)
Guntur,2008
Ronald, JADE 2016