Russian Federation
The article considers a case from expert practice, the example of which shows the difficulties that a forensic medical expert may face when establishing the etiopathogenesis of sepsis. Attention is drawn to the bacterial or fungal etiology of sepsis and the doubtfulness of the viral etiology. There is a relatively frequent occurrence of cryptogenic sepsis, when the primary infectious focus is not detected. Possible causes of this phenomenon are considered.
medical error, medical care defect, cryptogenic sepsis, pathogenesis, sepsis, septic shock, etiology
1. Belyh A.N., Bozhchenko A.P., Tolmachev I.A. Osobennosti semiotiki i metodologii medicinskoy diagnostiki i svyazannye s nimi prichiny gnoseologicheskih oshibok // Medicinskaya ekspertiza i pravo. 2016. № 6. S. 14-19.
2. Bozhchenko A.P., Tolmachev I.A., Belyh A.N. Nastuplenie letal'nogo ishoda vsledstvie yatrogennogo povrezhdeniya vetvi mezhrebernoy arterii pri provedenii plevral'noy punkcii // Sudebno-medicinskaya ekspertiza. 2019. № 6. S. 58-62.
3. Intensivnaya terapiya: nacional'noe rukovodstvo: v 2 t. / pod red. I.B. Zabolotskih, D.N. Procenko. 2-e izd., pererab. i dop. Moskva: GEOTAR-Media, 2020. T. 2. 1056 s.
4. Nazarov Yu.V., Bozhchenko A.P. Povrezhdenie tela cheloveka piloy: sluchay iz ekspertnoy praktiki // Materialy XII Vserossiyskoy nauchno-prakticheskoy konferencii «Aktual'nye voprosy kliniki, diagnostiki i lecheniya v mnogoprofil'nom lechebnom uchrezhdenii» (20-21 aprelya 2016 goda). SPb.: VMedA, 2016. S. 309.
5. Nacional'nye rekomendacii «Ostroe povrezhdenie pochek: osnovnye principy diagnostiki, profilaktiki i terapii». 2016. 142 s.
6. Prikaz MZ RF ot 10.05.2017 № 203n «Ob utverzhdenii kriteriev ocenki kachestva medicinskoy pomoschi».
7. Prikaz MZ RF ot 15.11.2021 № 919n «Ob utverzhdenii Poryadka okazaniya medicinskoy pomoschi vzroslomu naseleniyu po profilyu «anesteziologiya i reanimatologiya»».
8. Semenov S.L., Karev V.E., Bozhchenko A.P. Sluchay smerti rebenka, skoropostizhno umershego v rezul'tate generalizovannoy virusnoy infekcii / Patologicheskaya anatomiya: tradicii i sovremennost': sbornik nauchnyh trudov Vserossiyskoy konferencii, posvyaschennoy 160-letiyu kafedry patologicheskoy anatomii VMedA imeni S.M. Kirova (19 aprelya 2019 goda, Sankt-Peterburg). SPb.: VmedA, 2019. S. 106-111.
9. Sepsis: klassifikaciya, kliniko-diagnosticheskaya koncepciya i lechenie / Pod red. akad. RAN B.R. Gel'fanda. 4-e izd., dop. i pererab. Moskva: OOO «Medicinskoe informacionnoe agentstvo», 2017. 408 s.
