Difficulties in the treatment of acute sepsis

SUMMARY. The problem of acute sepsis as a polyetiological acyclic disease with peculiar clinical symptoms and diagnostic difficulties, which requires special treatment, is considered. Acute sepsis is the main and most common clinical form of this disease. The predictors of acute sepsis and the variety of clinical manifestations of its two classical stages – septicemia and septicopyemia – are characterized in detail. A typical case of acute sepsis, which was diagnosed only later, is given. In this regard, etiotropic therapy was delayed. Therefore, despite powerful etiotropic therapy, the disease was not limited to acute sepsis, but continued in the form of infectious (septic) endocarditis. The septic nature of infectious endocarditis is due to the presence and persistence of a septic focus in the endocardium, as well as the course of the disease in the form of continuous growth of local inflammatory and destructive changes in primary septic foci and general infectious-metastatic, thromboembolic and immune complex manifestations, which in the absence of special treatment lead to an inevitable fatal outcome, that is, the development of a disease such as sepsis acyclicity. The diagnosis of infective endocarditis is based on the detection of initially reasonably suspicious clinical and then evident paraclinical signs of the disease. Classical clinical and morphological signs of infectious endocarditis, as well as general principles of therapy of such patients, are given.