The Inflammatory and Hemostatic Response in Sepsis and Meningococcemia

Crit Care Clin. 2020 Apr;36(2):391-399. doi: 10.1016/j.ccc.2019.12.005. Epub 2020 Jan 30.

Abstract

Meningococcemia is notorious for evasion of the host immune system and its rapid progression to fulminant disease, and serves as a unique model for pediatric sepsis. Illness severity is determined by complex interplays among host, pathogen, and environment. The inflammatory host response, including proinflammatory and anti-inflammatory responses in innate and adaptive immunity, skews toward a proinflammatory state. This leads to endothelial dysfunction and activation of the hemostatic response, which may lead to disseminated intravascular coagulation. This article reviews the pathogenesis of sepsis, in particular the inflammatory and hemostatic response in meningococcal sepsis.

Keywords: Bacteremia; Bacterial infections; Hemostasis; Host-pathogen interaction; Inflammation; Meningococcal infections; Physiology; Sepsis.

Publication types

  • Review

MeSH terms

  • Bacteremia / microbiology
  • Bacteremia / physiopathology
  • Blood Coagulation Disorders / microbiology*
  • Blood Coagulation Disorders / physiopathology
  • Critical Illness
  • Host-Pathogen Interactions*
  • Humans
  • Inflammation / microbiology*
  • Inflammation / physiopathology
  • Meningococcal Infections / physiopathology*
  • Multiple Organ Failure / microbiology*
  • Multiple Organ Failure / physiopathology
  • Sepsis / physiopathology*