Infectious Disease and Sepsis
This domain tests sepsis recognition, antimicrobial timing, source control, meningitis, and infection precautions. The exam expects early risk stratification and avoidance of diagnostic delays.
Core rules
- Sepsis is infection with life-threatening organ dysfunction; septic shock includes persistent hypotension requiring vasopressors and elevated lactate.
- Obtain cultures promptly, but do not delay antibiotics for cultures in septic shock.
- Give broad-spectrum antibiotics within 1 hour for septic shock and for high-likelihood sepsis.
- Start balanced crystalloid resuscitation and reassess perfusion; use vasopressors when hypotension persists.
- Source control is essential: drain abscesses, remove infected devices, and involve surgery early.
Worked example
A patient with fever, hypotension, and lactate 5 mmol/L has suspected septic shock. Draw blood cultures, give antibiotics and fluids immediately, and search for a source. Do not wait for imaging before antibiotics if the patient is unstable.
Traps
- Do not use lactate alone to exclude sepsis.
- Do not give antibiotics without considering source control.
- Do not miss meningitis in a patient with headache and fever; perform lumbar puncture when safe after stabilisation.
- Do not ignore infection-control precautions while resuscitating.