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Ankit Sakhuja, MD; Shipra Gupta, MD; Kianoush Kashani, MD, FCCP
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FINANCIAL/NONFINANCIAL DISCLOSURES: See earlier cited article for author conflicts of interest.

aDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN

bDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN

cHospital Medicine, Mayo Clinic Health System, Mankato, MN

CORRESPONDENCE TO: Ankit Sakhuja, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, 200 First St SW, Rochester, MN 55905


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2017;151(3):724. doi:10.1016/j.chest.2016.11.023
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We appreciate the comments by Drs. Meurs et al on our study detailing the epidemiology and outcomes of culture negative severe sepsis. We agree with the authors that systemic inflammatory response syndrome (SIRS) symptoms can be elicited by not only infections (identified or unidentified), but also other inflammatory conditions. It is, however, important to understand that these patients who qualify for the definition of severe sepsis but are in fact culture negative (ie, have culture negative severe sepsis) are a distinct cohort of patients with worse outcomes and therefore need to be looked at more carefully during evaluations. Our study provides an important groundwork for designing future studies to investigate and improve outcomes for this distinct population. It will also be important to see how this cohort changes with the adoption of the new definition of sepsis. Rather than defining a new term, the aim of our study was to describe and direct attention toward this vulnerable population. We would, therefore, propose to avoid using the new terminology of SIRS-unknown origin as suggested by the authors, especially because SIRS criteria are going out of favor for more updated definitions of sepsis.

References

Gupta S. .Sakhuja A. .Kumar G. .McGrath E. .Nanchal R.S. .Kashani K.B. . Culture-negative severe sepsis: nationwide trends and outcomes. Chest. 2016;150:1251-1259 [PubMed]journal. [CrossRef] [PubMed]
 
Singer M. .Deutschman C.S. .Seymour C.W. .et al The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801-810 [PubMed]journal. [CrossRef] [PubMed]
 

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References

Gupta S. .Sakhuja A. .Kumar G. .McGrath E. .Nanchal R.S. .Kashani K.B. . Culture-negative severe sepsis: nationwide trends and outcomes. Chest. 2016;150:1251-1259 [PubMed]journal. [CrossRef] [PubMed]
 
Singer M. .Deutschman C.S. .Seymour C.W. .et al The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801-810 [PubMed]journal. [CrossRef] [PubMed]
 
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