A lot of drugs and efforts to treat sepsis/SIRS with inflammation have fizzled in trial. Tocilizumab, JAK inhibitors, and particaularly dexamethasone with its low NNT in COVID were interesting ones and suggest there is something to it but a complicated issue.

My condolences.

I had SIRS/sepsis once and it really is a harrowing experience. It really changed me forever and as a bonus, if not to add insult to injury, my hair now falls out and barely grows. Wouldn't wish it on my worst enemy.

This company https://cytovale.com/ has developed a diagnostic tool for sepsis, while not a cure it hopefully would make cases like your friend’s less likely

Also https://inflammatix.com/

I'm sorry. The same thing happened to a very close friend of mine. Sepsis is a bitch, and also I miss my friend all the time. I hope you have a community to support you in grief.

Its horrifying how many stories sound like that, like the recent story woman who got parasitic worms from Hawaiian food that crept upwards from her legs gradually causing pain until they made it to her brain and only then the cognitive impairment made doctors take her seriously. She kept getting sent home too.

It's infuriating how many problems in our lives are met with a shrug.

edit: I'm a jerk, I forgot we were talking about somebody close to you. I'm sorry about your friend and I hope you're doing okay.

> It's infuriating how many problems in our lives are met with a shrug

If you know anyone in medicine you know that those cases are swamped by the hypochondriacs, frauds and crazies. Absent a clear diagnostic system, or a person privately funding the search costs, with time and money, it’s infeasible to expect a collectively-funded system to explore every potential case like an episode of House MD.

This is pretty hand-wavy. I was diagnosed with a rare disorder. My doctors said surgery was the only option and that it would be fine after. As it turns out, there's a radiation therapy that is 80% successful, been practiced around the world for 20 years with no serious side effects (including cancer), AND is practiced regularly by a RO here where I live.

I had to find out about him by myself because my doctors didn't do anything other than look up my condition and give me the most common treatment option. In my case surgery usually makes things worse and is NOT advised other than as a last resort. My doctors didn't know any of this, because they didn't do their research.

Or could be they knew the surgeon and send them business

Rescue treatments are symptomatic. Which makes a lot of sense, if you consider what (medically) constitutes "sepsis."

Any ED resident on their first week on the job should know how to diagnose sepsis: Temp >38°C (100.4°F) or <36°C (96.8°F), Heart rate >90, Respiratory rate >20 or PaCO₂ <32 mm Hg, WBC >12,000/mm³, <4,000/mm³, or >10% bands, Infection (suspected or present).

Double down on the blood work, take liquor, empirically give antibiotics (less and less useful, given resistances), drop temperature (paracetamol), add fluids (drops heart rate, ups blood pressure), wait for labs.

It's not hard, and I am so very sorry someone with sepsis signs was sent home. Sepsis is also a fast bastard. Meaning, from pathogen entering the blood stream to organ damage and conclusively death can be less than half an hour. That's the ones we can't catch. The guy with the ulcer, the person who injects things, the girl who didn't see a dentist about her developing abscess, the man who stopped his HIV meds... that's the ones I didn't in the past three weeks. I got them too late, or didn't see them until the ambulance unloaded a dead person.

Sepsis is a bitch. A total and utter bad player, something we drill into every resident from day one. Sometimes Mrs. Goodforall comes in with a light chest tightness and leaves on a hearse, sometimes Mr. Bluebird presents with nausea and crashes into a full on septic shock minutes later. Any one of those I can prevent, I will. I am, however, not God. Just a ED jockey with an infectious disease background. I'm probably the best hope my patients have, which isn't much, but it's something.

Thank you; yes, he had a clinical history of colitis and other stomach issues, and had visited the ER due to abdominal pain over a weekend. On Tuesday he collapsed at home and was gone. I don't know what transpired with the doctor (and didn't want to pry too much with the grieving family) but it sounds like it was just missed or his symptoms misunderstood. I heard grumblings that the doctor was at fault but I don't fault them - things just happen and while it is sad, it just happens.

What about the research surrounding high dose vit C, thiamine, dexamethasone or whatever that concoction was?

If I understand correctly, this is one of those laws-of-exponents things that humans tend to have bad intuition for, right?

Bacteria growth, unchecked, is exponential. The only reason we stay a coherent organism at all in this crazy world of trillions of other organisms is that our immune system checks the hell out of bacteria growth.

... but when that's no longer possible, when the body goes from being a hostile growth environment to food... enterococcus faecalis has a doubling time of 18 minutes. One such cell, with completely-unchecked reproduction, would produce a number of itself to rival the cell-count of the entire body in only 10 hours, and it takes way less than 30 trillion enterococcus to kill a person.