The clinical impact of computed tomography in patients with sepsis of unknown origin: A systematic review

Introduction: The identification of occult sources of infection is of paramount importance to improve the outcomes of patients with sepsis. Aim: The investigation of the clinical impact of computed tomography (CT) scans in patients with sepsis of unknown origin. Methods: A systematic review of studies published up to December 2016 in PubMed and Scopus databases was conducted, with the following key-words: “'sepsis”, “severe sepsis”, “septic shock”, “unknown origin”, “computed tomography” and “CT”. The keywords were searched in the title and abstract of the studies, while the filters "human" and "English language" were used. The inclusion criteria in this review were: studies should concern patients sepsis or severe sepsis or septic shock of unknown origin, as well as patients having undergone CT or positron emission tomography (PET/CT). Results: Of the published studies, 5 met the inclusion criteria. The results of the studies showed that in all of the 75 and 89 patients underwent PET/CT and CT, true positive findings showed in 50 (66.66%) and in 29 (35%) patients, respectively, while in 23 out of 50 (46%) and in all of the 29 (100%) patients, findings led to the selection of the appropriate therapeutic intervention or led to a change in the initial chosen treatment. Conclusions: CT and PET/CT are valuable tools in identifying occult sources of infection in patients with sepsis or severe sepsis or septic shock, contributing to the selection of the appropriate therapeutic intervention and leading to higher rates of survival.

Keywords: Computed Tomography, sepsis, unknown origin