I would assume that the altered mental status is more likely due to the local infection and not to systemic manifestations of the infection, therefore not severe sepsis. Even in infections outside of the CNS, altered mental status is always a tricky one to use as an organ dysfunction in sepsis as it can be altered at baseline or due to medications that a sick patient is getting, particularly if mechanically ventilated. It is not typically allowed as an organ dysfunction when enrolling patients in clinical trials of severe sepsis.
From: [email protected] [mailto:[email protected]] On Behalf Of Joseph Clement Sent: Thursday, February 13, 2014 8:21 PM To: [email protected] Subject: [Sepsis Groups] Severe Sepsis and Meningitis Hello For a patient with sepsis due to meningitis, and who has mild-moderate altered mental status as their only organ dysfunction (lactate, BP, Creatine, etc all normal), would you consider this to be "severe sepsis", or would you require end organ involvement distant from the infection source? Thanks very much, Joe Joseph Clement RN, MS, CCNS Clinical Nurse Specialist San Francisco General Hospital phone: (415) 206-6174 pager: (415) 327-0220 [email protected]<mailto:[email protected]> **************************************************************** This communication, including attachments, may contain information that is confidential. It constitutes non-public information intended to be conveyed only to the designated recipient(s). If the reader or recipient of this communication is not the intended recipient, employee, or agent of the intended recipient who is responsible for delivering it to the intended recipient, or you believe that you have received this communication in error, please notify the sender immediately by return e-mail or telephone and promptly delete this e-mail, including attachments without reading them or saving them in any manner. The unauthorized use, dissemination, distribution, or reproduction of this e-mail, including attachments, is prohibited and may be unlawful.
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