Clinical Case Database / Category: Clinical Care

Management of severe sepsis and septic shock

Publication details

Dr Alison Bowden, Dr Ben Chadwick
Foundation Years Journal, volume 4, issue 5, p.31 (123Doc Education, London, May 2010)


Mrs B was an 82-year-old woman who was referred to hospital by her GP, after collapsing at home. She normally lived alone with twice daily visits from carers due to mild cognitive impairment. The care assistant who visited in the morning had noticed that Mrs B had been more confused than normal and had alerted her daughter; she had visited later to find Mrs B collapsed on the floor, incontinent of urine and confused. Mrs B had a past medical history of hypertension, for which she took amlodipine and ramipril, and diet controlled type 2 diabetes mellitus. She had no other significant co-morbidities and no allergies. A similar episode 1 year earlier had resulted in a hospital admission and had been attributed to a urinary tract infection. On that occasion she had responded to treatment with antibiotics and had been discharged from hospital after 1 week with her current care package.

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Dr Alison Bowden

Foundation Year 1 Doctor
Southampton University Hospitals NHS Trust
Tremona Road
SO16 6YD

Dr Ben Chadwick

Consultant in Acute Medicine
Southampton University Hospitals NHS Trust


1.  Dellinger RP, Levy MM, Carlet JM, et al. (2008) Surviving Sepsis Campaign: International guidelines for the management of severe sepsis and septic shock. Critical Care Medicine, 36:296–327.

2.  Surviving Sepsis Campaign website,

3.  Finfer S, Bellomo R, Boyce N, et al. (2004) A comparison of albumin and saline fluid resuscitation in the intensive care unit. New England Journal of Medicine, 350:2247–2256.

4.  Roseveare C (2009) Acute medicine; clinical cases uncovered. John Wiley and Sons, p. 240.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.