Table 2.

 Examples of factors affecting signs and symptoms of sepsis

Factor and organism	Site	Effect
Virulence of pathogen
Streptococcus pyogenes	Skin	Cellulitis, with fever, localised pain, and redness
Streptococcus pyogenes + SPE-C	Skin	Toxic shock, with hypotension, oliguria, altered mental status, and coagulopathy
Bioburden
Salmonella typhimurium, 103 colony forming units	Gut	Borborygmi and loose stools
Salmonella typhimurium, 105 colony forming units	Gut	Haemorrhagic colitis with fever, abdominal discomfort
Portal of entry
Klebsiella pneumoniae	Renal tract	Pyelonephritis with fever, tachycardia, hypotension, loin pain
Klebsiella pneumoniae	Chest	Lobar pneumonia with high fever, rigors, myalgia, productive cough, tachypnoea, tachycardia, and hypotension
Host susceptibility
Streptococcus pneumoniae	Chest, fit adult	Pneumonia, with fever, sweats, dyspnoea, and pleuritic chest pain
Streptococcus pneumoniae	Chest, elderly	Obtundation or confusion and “off legs”
Temporal evolution
Neisseria meningitidis	Blood, early	Fever, malaise, myalgia, arthralgia, headache, but no localising signs
Neisseria meningitidis	Blood, late	Septic shock, with hypotension, oliguria, altered mental status, and widespread purpuric rash

SPE-C=streptococcal pyrogenic exotoxin C.