Comparative study of the prevalence of sepsis in patients admitted to dermatology and internal medicine wards

Abstract

BACKGROUND Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively.

Leprosy suspect presenting at a chest clinic

“…6 Mortality from sepsis in patients with leprosy is well-known and occurs as a result of secondary infection, additional reactional effects of ulcerations and use of corticosteroids. 7,8 Unfortunately, in our case, we could not identify the infectious agent, to support our conclusion of septic shock. 9 However, on retrospection, the high fever, polymorphonuclear leukocytosis, and erythematous inflamed subcutaneous nodules were consistent with an Erythema Nodosum Leprosum reaction, and upper respiratory tract symptoms such as nasal congestion, hoarse voice and high-pitched inspiratory crowing with prolonged expiration time, were consistent with upper respiratory mucosal and laryngeal involvement of lepromatous leprosy.…”