CT Chest, Abdomen, and Pelvis Without and With IV Contrast There are no data to support the use of any added value of a CT chest, abdomen, and pelvis without IV contrast immediately before acquisition of a contrast-enhanced CT in the diagnosis of sepsis. CT Chest With IV Contrast Pohlan et al [6] in a retrospective study of 357 ED patients with suspected sepsis, of whom 132 underwent CT scan within 72 hours of admission, the most commonly identified source of infection, which the authors refer to as septic foci, was in the chest (pneumonia) reported in 38.6% (49/127) of patients. A PPV of 81.82% (CI 76.31%-86.28%) was calculated for a septic focus identified by CT. However, the NPV was only 21.74% (CI 10.73%-39.11%). Patients with suspected sepsis who received a CT within 72 hours of admission were given a final diagnosis of sepsis in 93.3% of cases (124/132). The detection of septic foci in 76.5% of CTs results in a high diagnostic yield for CT in septic ED patients, particularly in patients who are extremely ill and/or require ICU admission. Just et al [7] performed a single-center 1 year retrospective study of all CT scans of the chest and/or abdomen ordered in pursuit of suspected infection in surgical ICU patients. A source of infection was found in 76/144 of cases (52.8%) and resulted in a change of management in 65/144 (45%) of patients, including a change in antimicrobial regimen, surgery, and nonsurgical interventions such as placement of drainage catheters. A pathologic infectious source was found in the chest in 72% of patients who underwent chest CT. Use of IV contrast was not specified in this study. Furthermore, preceding diagnostic procedures including chest radiography were not recorded. CT Chest Without and With IV Contrast There are no data to support the use of any added value of a CT chest without IV contrast immediately before acquisition of a contrast-enhanced CT in the diagnosis of sepsis.
Sepsis. CT Chest, Abdomen, and Pelvis Without and With IV Contrast There are no data to support the use of any added value of a CT chest, abdomen, and pelvis without IV contrast immediately before acquisition of a contrast-enhanced CT in the diagnosis of sepsis. CT Chest With IV Contrast Pohlan et al [6] in a retrospective study of 357 ED patients with suspected sepsis, of whom 132 underwent CT scan within 72 hours of admission, the most commonly identified source of infection, which the authors refer to as septic foci, was in the chest (pneumonia) reported in 38.6% (49/127) of patients. A PPV of 81.82% (CI 76.31%-86.28%) was calculated for a septic focus identified by CT. However, the NPV was only 21.74% (CI 10.73%-39.11%). Patients with suspected sepsis who received a CT within 72 hours of admission were given a final diagnosis of sepsis in 93.3% of cases (124/132). The detection of septic foci in 76.5% of CTs results in a high diagnostic yield for CT in septic ED patients, particularly in patients who are extremely ill and/or require ICU admission. Just et al [7] performed a single-center 1 year retrospective study of all CT scans of the chest and/or abdomen ordered in pursuit of suspected infection in surgical ICU patients. A source of infection was found in 76/144 of cases (52.8%) and resulted in a change of management in 65/144 (45%) of patients, including a change in antimicrobial regimen, surgery, and nonsurgical interventions such as placement of drainage catheters. A pathologic infectious source was found in the chest in 72% of patients who underwent chest CT. Use of IV contrast was not specified in this study. Furthermore, preceding diagnostic procedures including chest radiography were not recorded. CT Chest Without and With IV Contrast There are no data to support the use of any added value of a CT chest without IV contrast immediately before acquisition of a contrast-enhanced CT in the diagnosis of sepsis.