Stille W
Infection. 1976;4(4):224-30. doi: 10.1007/BF01638931.
The internationally accepted term septicaemia is used to describe illnesses in which pathogenic microorganisms are present in the blood. Septicaemia should be defined according to the causative organism, the portal of entry and the underlying disease. In the last 16 years the causative organisms in 788 cases of septicaemia in our hospital were found to be gram-positive cocci in 28.1% gram-negative rods in 37.6%, and other organisms in 24.i%. Infections with Psuedomonas in particular have become more frequent in recent years. The range of causative organisms in septicaemia varies considerably with the patient groups involved. Thus patients with myeloid insufficiency contracted primarily gram-negative septicaemia. As in the past, the pathogens in endocarditis today are primarily streptococci. In hemodialysis staphylococci and gram-negative rods are shown to occur with equal frequency. The most important clinical manifestation of septicaemia is fever with rigor. The poor prognosis in gram-negative septicaemia is mainly due to the onset of septic shock. Skin colonisation is often a typical sign of septicaemia and can also sometimes serve as a diagnostic indication. Hemorrhagic pustules surrounded by a zone of inflammation are typical in septicaemia caused by meningococci or gonococci. Skin eruptions are rare in septicaemia caused by streptococci of staphylococci. Whereas skin eruptions are absent in septicaemia due to enterobacteria, they are very often present in septicaemia caused by Pseudomonas. In bacterial endocarditis a wide variety of skin lesions can occur.
国际上通用的术语“败血症”用于描述血液中存在致病微生物的疾病。败血症应根据病原体、感染途径及基础疾病来定义。在过去16年中,我院788例败血症病例的病原体中,革兰氏阳性球菌占28.1%,革兰氏阴性杆菌占37.6%,其他病原体占24.1%。近年来,尤其是铜绿假单胞菌感染变得更为常见。败血症病原体的种类因患者群体不同而有很大差异。因此,骨髓功能不全患者主要感染革兰氏阴性败血症。与过去一样,如今心内膜炎的病原体主要是链球菌。在血液透析患者中,葡萄球菌和革兰氏阴性杆菌的感染频率相同。败血症最重要的临床表现是发热伴寒战。革兰氏阴性败血症预后不良主要是由于感染性休克的发生。皮肤定植常常是败血症的典型体征,有时也可作为诊断依据。由脑膜炎球菌或淋球菌引起的败血症典型表现为周围有炎症带的出血性脓疱。由链球菌或葡萄球菌引起的败血症很少出现皮疹。而由肠杆菌引起的败血症无皮疹,由铜绿假单胞菌引起的败血症则常常出现皮疹。在细菌性心内膜炎中可出现各种各样的皮肤病变。