Abstract
SEPTIC (bacterial) shock usually develops as a complication of overwhelming infection.<sup>1</sup>The majority of cases are secondary to gram-negative aerobic bacilli; however, gram-positive organisms account for a smaller but significant proportion of cases. Shock develops in 25% to 50% of patients with gram-negative bacteremia.<i>Escherichia coli</i>remains the predominant pathogen in most series of septic shock, followed by the<i>Klebsiella</i>group and<i>Pseudomonas</i>species. Both the<i>Staphylococcus</i>and<i>Streptococcus</i>species account for most of the gram-positive infections. The genitourinary tract is the most common site of infection, with the gastrointestinal and respiratory tracts as the next most frequent sources of sepsis. Other common foci include the skin and wounds, the central nervous system, and infected intravenous catheters. Sepsis is not usually complicated by shock in persons younger than 40 years of age, except in young women during pregnancy, infants during the neonatal period, and patients with impairment of host
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