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Clinical approach 

Clinical approach
Chapter:
Clinical approach
Author(s):

Christopher J. Ellis

DOI:
10.1093/med/9780198746690.003.0069
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date: 25 February 2021

The clinical approach to patients with likely infection begins with a focused history, leading on to a clinical examination which assesses the extent of the physiological derangement and looks for a focus of infection. Standard physiological measures define likely sepsis (see Chapter 8.1.2), which is the commonest reason for their sudden derangement in hospitalized patients. Investigations should be phased and must not delay the start of potentially life-saving treatment, the response to which must be carefully followed, especially when treatment has to be started before a complete or certain diagnosis is possible, and compared with the likely speed of response for the putative condition being treated. There is increasing evidence that delays in initiating appropriate therapy, especially antimicrobial medication and circulatory support, increase mortality.

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