Initial Laboratory Evaluation for Sepsis:
Complete Blood Count (CBC) with Differential: To assess for leukocytosis, leukopenia, or bandemia, which are common in sepsis. –
Basic Metabolic Panel (BMP): To evaluate electrolyte imbalances, renal function, and metabolic acidosis. –
Liver Function Tests (LFTs): To detect hepatic dysfunction, which may indicate severe sepsis or organ dysfunction. –
Serum Lactate: Elevated levels (>2 mmol/L) suggest tissue hypoperfusion and are a key marker for sepsis severity. –
Coagulation Panel (PT/INR, aPTT): To screen for disseminated intravascular coagulation (DIC), which can complicate sepsis. –
Urinalysis: To identify potential urinary tract infections as a source of sepsis. – Point-of-Care Pathogen Testing: When available, to rapidly identify pathogens (e.g., PCR for respiratory viruses, blood culture bottles). –
Microbiologic Testing:
Blood Cultures: At least two sets from separate sites before antibiotic initiation to identify the causative organism. –
Other Site-Specific Cultures: Depending on suspected source (e.g., sputum, urine, cerebrospinal fluid, wound swabs). –
Additional Considerations:
Empiric Antibiotic Therapy: Prompt initiation is critical; delay increases mortality. Selection should be broad-spectrum initially, tailored based on local resistance patterns and suspected source. –
Source Control: Identify and manage the infection source (e.g., drainage of abscesses, removal of infected devices).
Rationale: Early, comprehensive diagnostic testing and empiric therapy are essential to reduce morbidity and mortality in sepsis, as per guidelines (e.g., Surviving Sepsis Campaign).