22.2.2 Signs of Septic Shock
High or very low body temperature
Tachypnea (>20 breaths per minute)
Heart rate (>20 beats per minute)
Extreme weakness
Cool, pale arms and legs
Restlessness, agitation, lethargy, or confusion
Late hypotension [5]
22.3 Supplementary Investigations
22.3.1 Haematological Investigations
Complete blood count, hepatic and renal function, fibrinogen, prothrombin, thrombocytes, C-reactive protein
Blood culture [6]
22.3.2 Skin Biopsy
The diagnosis is mainly clinical; therefore, the skin biopsy is rarely necessary. It demonstrates occlusive vasculopathy, nonspecific dermal inflammation, red cell extravasation, subepidermal cell-poor bulla, and purpura simplex [7].
22.4 Treatment
It implies the treatment of the underlying cause associated with intensive supportive care.
Antibiotics: Third-generation cephalosporin (intravenous administration)
Volume expansion
Tissue oxygenation
Aggressive and sequential debridement of necrotic tissue to decrease the risk of sepsis. Wounds are then covered with an antiseptic ointment (for e.g., silver sulphadiazine cream). Sometimes fasciotomia, skin grafts and even amputations are needed
Thus, treatment includes aggressive management of the septic state and management of skin lesions [8, 9, 10].
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