Sepsis & Surgical Infections

A 67-year-old postoperative patient is hypotensive, tachypneic, and confused with suspected intra-abdominal source. Which definition best fits sepsis?

In suspected sepsis outside the ICU, which bedside screening tool is most appropriate to flag high risk?

A 72-year-old with septic shock after perforated colon received cultures. What is the antibiotic timing?

Which initial fluid strategy is recommended in septic shock resuscitation?

A patient with suspected sepsis has lactate 5.2 mmol/L. What is the best use of this lab?

Source control in surgical sepsis is best described as:

A 58-year-old with perforated diverticulitis and peritonitis. Best empiric regimen?

Postoperative patient with hemodynamic instability and diffuse peritonitis. Priority?

Which regimen adds toxin suppression in necrotizing streptococcal infection?

A 45-year-old with Fournier’s gangrene. Best initial management?

Gas in muscle with crepitus and sepsis after farm injury. Most appropriate antibiotics?

Ascending cholangitis with hypotension and jaundice. Next step?

A 33-year-old with suspected anastomotic leak after colectomy. Best diagnostic/therapeutic approach?

Intra-abdominal sepsis, which antifungal indication is most appropriate?

Severe cellulitis after seawater exposure. Empiric addition?

Clostridioides difficile fulminant colitis with ileus and sepsis. Best regimen?

Diabetic foot infection with systemic toxicity and crepitus in calf. Priority?

Catheter-related bloodstream infection due to S. aureus. Most critical step?

Perforated appendicitis with abscess 5 cm. Best management?

Which prophylaxis principle is correct for clean-contaminated colorectal surgery?

Timing for surgical antibiotic prophylaxis (cefazolin) is:

MRSA risk in prosthetic hernia repair. Best prophylactic choice?

Duration of routine surgical prophylaxis after clean procedures:

Postoperative day 5 fever with erythema, warmth, and purulent drainage from incision. Initial step?

A 59-year-old cirrhotic with spontaneous bacterial peritonitis (PMN ≥250). Best therapy?

Which pathogen classically causes overwhelming post-splenectomy sepsis?

Severe postoperative pneumonia with septic physiology and risk for Pseudomonas. Empiric approach?

A patient with perforated gastric ulcer and septic shock. Which antifungal choice is best avoided as monotherapy initially?

Necrotizing soft-tissue infection suspected. Which imaging is acceptable but must not delay OR?

Intra-abdominal cultures grow ESBL E. coli after source control. Best targeted therapy?

What is the optimal duration of antibiotics after adequate source control in complicated intra-abdominal infection?

Patient on day 2 after laparotomy develops fever, tachycardia, and foul drainage from a subfascial collection. Best step?

A 64-year-old with S. aureus bacteremia after infected graft excision. Additional evaluation?

Which biomarker can support early antibiotic de-escalation when values are low/falling?

Human bite to the hand with cellulitis and lymphangitis. Empiric therapy?

Postoperative day 1 low-grade fever in a stable patient without focal signs. Best approach?

A 70-year-old with acute calculous cholecystitis and sepsis. Best overall strategy?

Toxic megacolon with septic deterioration due to fulminant colitis. Surgical choice?

Intra-abdominal infection after bariatric surgery with Candida glabrata in cultures. Preferred antifungal?

Surgical-site infection prevention for prosthetic mesh hernia repair includes:

A stable postoperative patient started on broad-spectrum antibiotics for suspected sepsis now has negative cultures and clear noninfectious cause. What is the best step?

Early deep sternal wound infection (mediastinitis) after CABG presents with fever, chest pain, purulent drainage, and instability. Optimal management?

A post-bariatric patient POD#2 has persistent tachycardia (>120), fever, and abdominal pain. CT equivocal; patient is deteriorating. Next step?

During elective colectomy there is gross fecal spillage. How should perioperative antibiotics be handled?

Septic patient with new AKI (eGFR 20 mL/min) is on piperacillin-tazobactam and vancomycin. What principle applies?

Which mechanism primarily drives vasodilation in sepsis?

Infected prosthetic vascular graft with bacteremia. Best definitive management?

Grade III (severe) acute cholecystitis with organ dysfunction. Best initial strategy?

Post-splenectomy patient with fever and rigors. What is the immediate action?

Which perioperative measure reduces surgical-site infection (SSI) risk?

Glycemic management to lower SSI risk in surgical patients should target: