New Insights in the Diagnosis and Treatment of Sepsis and Septic Shock: From Prevention to Multiorgan Failure

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Intensive Care/ Anesthesiology".

Deadline for manuscript submissions: 15 July 2026 | Viewed by 2582

Special Issue Editors


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Guest Editor Assistant
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany
Interests: sepsis; clostridiacae; bacterial superinfection; septic shock; intensive care; liver disease

E-Mail Website
Guest Editor Assistant
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany
Interests: intensive care medicine; critical care; liver diseases and immunology; sepsis

E-Mail Website
Guest Editor
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany
Interests: intensive care; sepsis; liver disease; biomarkers; critical care

Special Issue Information

Dear Colleagues,

Despite advances in critical care medicine, sepsis remains one of the most common causes of death in the intensive care unit. Sepsis is a condition characterized by elevated systemic levels of both pro- and anti-inflammatory cytokines, and an initial phase of excessive inflammation is followed by a state of immunosuppression. Viral, fungal or bacterial infections can trigger the cytokine storm that leads to this devastating systemic syndrome. As many other pathological conditions can imitate sepsis, diagnosis is often delayed. Moreover, current biomarkers are nonspecific and are influenced by other underlying conditions, like liver cirrhosis or rheumatological diseases.

Regarding the treatment of sepsis, current guidelines recommend fluid resuscitation and early administration of antibiotics. While some attempts have been made to target the cytokine storm, current results are rather discouraging.

This Special Issue aims to deal with cutting-edge research regarding diagnosis, new pathophysiological discoveries or treatment of critically ill patients with sepsis or septic shock. Precise biomarkers for diagnosis, prediction or prognosis could shed light on our understanding of the pathophysiology of this syndrome. Furthermore, advancements in point-of-care diagnostics could lead to timely recognition of sepsis, improve treatment, risk stratification, decipher sepsis phenotypes and monitor treatment response. Deeper insights into the cytokine storm may enrich our knowledge of new diagnostic and therapeutic approaches to this devastating condition.

Papers addressing prevention, epidemiology, diagnosis and treatment regarding all types of infections that can lead to sepsis are welcome as well.

Dr. Vlad Pavel
Dr. Patricia Mester
Guest Editor Assistants

Dr. Stephan Schmid
Guest Editor

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Keywords

  • sepsis
  • septic shock
  • multiorgan failure, infections in the critically ill
  • intensive care medicine
  • biomarkers
  • cytokines

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Published Papers (1 paper)

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20 pages, 956 KB  
Systematic Review
Non-Infectious Causes for Elevated Procalcitonin
by Stefan Lucian Popa, Victor Incze, Abdulrahman Ismaiel, Teodora Surdea-Blaga, Simona Grad, Daria Claudia Turtoi, Darius-Stefan Amarie, Liliana David, Vlad Dumitru Brata, Daniel Corneliu Leucuta, Ahmed Abdelghafar, Claudia Diana Gherman, Mihai Razvan Zahan and Dinu Iuliu Dumitrascu
Medicina 2026, 62(3), 464; https://doi.org/10.3390/medicina62030464 - 28 Feb 2026
Viewed by 2264
Abstract
Background and Objectives: Procalcitonin (PCT) is widely used to support the diagnosis of bacterial infection and sepsis, yet clinically relevant elevations also occur in multiple non-infectious conditions. This systematic review aimed to synthesize human evidence on non-infectious causes of elevated PCT and [...] Read more.
Background and Objectives: Procalcitonin (PCT) is widely used to support the diagnosis of bacterial infection and sepsis, yet clinically relevant elevations also occur in multiple non-infectious conditions. This systematic review aimed to synthesize human evidence on non-infectious causes of elevated PCT and to summarize proposed pathophysiological mechanisms, with the goal of supporting context-based interpretation in clinical practice. Materials and Methods: A systematic search of PubMed/MEDLINE, Embase, Web of Science, and Scopus was performed from inception to 31 July 2025. Human studies published in English reporting quantitative PCT values in non-infectious contexts were eligible (observational studies, clinical trials, and case series with ≥5 patients). Results: Seventy-six unique studies were included. Evidence was organized across systemic inflammatory responses, cardiovascular pathology, nephrological disorders and renal replacement therapy, pulmonary diseases, gastrointestinal and hepatopancreatic diseases, autoimmune and rheumatologic conditions, neurologic and ophthalmologic conditions, onco-hematologic disorders, surgery, traumatology and transplanted patients. Across conditions, non-infectious PCT elevations were variable and frequently overlapped with ranges reported in bacterial infection, particularly in settings characterized by severe sterile inflammation and tissue injury (e.g., major surgery, trauma, shock, pancreatitis, and burns), as well as in selected malignancies with tumor-associated PCT production. Conclusions: Elevated PCT is not synonymous with bacterial infection. Interpretation should emphasize clinical context, timing, and serial trends rather than isolated thresholds, especially in high-acuity settings with strong non-infectious inflammatory stimuli. Standardized reporting of assays and sampling time points and condition-specific kinetic data are needed to refine diagnostic and stewardship algorithms. Full article
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