REPLY
Update in Critical Care Medicine
John M. Luce, MD
15 June 1997 | Volume 126 Issue 12 | Page 1004
IN RESPONSE:
In their prospective study of the natural history of the systemic inflammatory response syndrome, Rangel-Frausto and colleagues [1] wrote that
In our study, half of the patients included in our definition of sepsis did not have a documented infection; however, they were prescribed antibiotics (median, 3 days) by their physicians for suspected infection. Outcomes in the group with culture-negative septic shock were similar to those meeting the criteria of the consensus conference of culture-proven septic shock.
In his letter, Dr. Johnson argues that, by definition, a condition cannot be termed sepsis, severe sepsis, or septic shock in the absence of confirmed infection; Rangel-Frausto and colleagues did not adhere to this distinction. Perhaps these authors should have used the term "apparent" in describing the sepsis-like state of their culture-negative patients with systemic inflammatory response syndrome. However, it was not in my province to make such a recommendation in summarizing the results of their study.
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Author and Article Information
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University of California, San Francisco, San Francisco, CA 94143
1. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP. The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA. 1995; 273:117-23.
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