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Table 2 Common Causes of Severe Sepsis by Organ System*

From: Initial Emergency Department Diagnosis and Management of Adult Patients with Severe Sepsis and Septic Shock

Organ Etiology Diagnostic Study
Lungs Pneumonia Chest radiograph
  -Hospital acquired CT scan of the chest
  -Community acquired  
Abdomen Appendicitis Abdominal radiograph
  Cholecystitis/Cholangitis CT scan of the abdomen and pelvis
  Bowel perforation Right upper quadrant abdominal ultrasound
  Peritonitis HIDA scan
Urinary Tract Cystitis Urine analysis and culture
  Pyelonephritis Renal ultrasound
  Urosepsis *Remove any instrumentation ie. Indwelling foley catheter
Skin Cellulitis Isolation and culture
  Wound  
Bones Osteomyelitis Bone scan or MRI
  Sinusitis CT scan of the maxillofacial bones and sinuses
Central Nervous System Meningitis/Encephalitis Lumbar puncture
  Spinal abscess MRI of the brain and/or spine
   CT scan of the brain
Blood Secondary from other source Blood culture
  Catheter associated *Remove any instruments that may seed infection ie. central line, pacemaker wires
Unknown *Approximately 20% of patients will have an unknown source.
  1. *Adapted from Levy et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit. Care Med. 2010;38(2):367–374.
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