Sepsis is one of the systemic inflammatory responses, and it can cause acute respiratory distress syndrome (ARDS). Mechanical ventilation (MV) is one of the best treatments in patients with sepsis related to ARDS. However, mechanical ventilation itself can cause lung injury through various mechanisms. In this study, we applied mouse cecal ligation and puncture (CLP) model of sepsis with subsequent injurious ventilation to determine if sepsis could affect the development of ventilator-induced lung injury (VILI). To evaluate lung injury caused by sepsis, mild, moderate, and severe CLPs were induced. To evaluate lung injury caused by MV with or without sepsis, tidal volume (7 mL/kg, 10 mL/kg, or 24 mL/kg) was maintained for 3 h with or without septic insult (mild sepsis for 72 h). Lung compliance was then determined and biochemical evaluations were performed. Results showed that lung compliance was lower in the severe sepsis group compared to that in the mild or moderate sepsis group. MV alone decreased lung compliance in a tidal volume dependent manner. Both CLP and VILI groups showed significant decrease in lung compliance and increase in total cell count upon bronchoalveolar lavage fluid. These results confirm that ventilation can affect lung injury in mouse sepsis model.

Sepsis is a clinical syndrome defined as a systemic inflammatory response to infection. Eritoran is a synthetic lipid A derivative that competes with lipopolysaccharide in binding to the identical site of myeloid differentiation-2/toll-like receptor 4 complex. Eritoran is effective in decreasing the septic mortality of Gram-negative bacteria-infected animals. Eritoran has been highlighted as a candidate drug for treatment of endotoxemia in phase I clinical studies with healthy human volunteers. A phase II trial of eritoran has been conducted in patients with severe sepsis. Intravenous infusion of eritoran reduced the mortality rate, as compared with the placebo group, in sepsis patients at a high risk of mortality according to acute physiology and chronic health evaluation-II scores. A phase III study of eritoran was completed in 2011. The results appear to be disappointing as no statistically significant difference in all-cause mortality was observed between the eritoran treatment group and the placebo group on day 28 in sepsis patients with a high risk of death. In this review, we focus on the rationale for the use of eritoran in treatment of sepsis as well as its clinical applications.

Several bacterial species from the Burkholderia cepacia complex (Bcc) are opportunistic pathogens that lead to infections in patients with underlying lung disease, such as cystic fibrosis, as well as in immunocompromised individuals. Included in the Bcc, Burkholderia contaminans is an emerging pathogen in cystic fibrosis patients. However, this is the first report case of sepsis due to Burkholderia contaminans without cystic fibrosis in child. And we report that successful treatment of sepsis due to Burkholderia contaminans in the child, through antibiotic therapy.

Ureteroscopic lithotripsy has higher stone free rate compared with extracorporeal shock wave lithotripsy. Ureteroscopyassociated complications are flank pain, transient hematuria, ureteral perforation, ureteral avulsion, and sepsis. Among these, sepsis is most serious complication with the incidence of about 1%. We report a case of sepsis and septic shock that developed immediately after ureteroscopic lithotripsy. It was diagnosed with elevated lactate and procalcitonin values. It was caused by Pseudomonas aeruginosa which was detected in preoperative urine culture and postoperative blood culture.

Severe maternal morbidity is frequently associated with catastrophic complications of pregnancy such as amniotic fluid embolism (AFE) or sepsis due to chorioamnionitis. The authors report a case of postpartum maternal hypoxic encephalopathy that might be attributed to AFE or sepsis due to chorioamnionitis with Escherichia coli bacteremia, and review the relevant literature. The patient presented with preterm labor, underwent Cesarean section for intrauterine fetal demise, and experienced postpartum cardiopulmonary collapse and disseminated intravascular coagulation, which led to catastrophic postpartum maternal encephalopathy.