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Core Concepts in Clinical Infectious Diseases (CCCID) Page left intentionally blank Core Concepts in Clinical Infectious Diseases (CCCID) Carlos Franco-Paredes, MD, MPH Division of Infectious Diseases, Phoebe Putney Physician Group, Albany GA; and Division of Infectious Diseases, Hospital Infantil de México, Federico Gómez, México City, México AMSTERDAM • BOSTON • HEIDELBERG • LONDON NEW YORK • OXFORD • PARIS • SAN DIEGO SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic Press is an imprint of Elsevier Academic Press is an imprint of Elsevier 125 London Wall, London EC2Y 5AS, UK 525 B Street, Suite 1800, San Diego, CA 92101-4495, USA 50 Hampshire Street, 5th Floor, Cambridge, MA 02139, USA The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK Copyright © 2016 Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN: 978-0-12-804423-0 For information on all Academic Press publications visit our website at http://store.elsevier.com/ Typeset by Thomson Digital Publisher: Sara Tenney Acquisition Editor: Linda Versteeg-buschman Editorial Project Manager: Halima Williams Production Project Manager: Julia Haynes Designer: Matt Limbert Dedication To Javi, Nico, Maribel, Lala, Maru, Manolo and Nona To my patients and colleagues during my training at Emory University, Atlanta GA “Pathogenicity is not the rule. Indeed, it occurs so infrequently and involves such a relatively small number of species, considering the huge population of bacteria on the earth, that it has a freakish aspect. Disease usually results from inconclusive negotiations for symbiosis, an overstepping of the line by one side or the other, a biologic misinterpretation of borders” Thomas L. Germs. N Engl. J Med 1972; 287:553. “So close no matter how far…” Nothing Else Matters by Metallica Page left intentionally blank Contents Preface xi 1. Sepsis Diagnostic Approach to Sepsis Infection Sepsis Hospital Acquired Sepsis Community Acquired Sepsis References 2. Bloodstrea