Sepsis on Biologics — SCE Rheumatology MCQ
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Correct answer: E — Treat as sepsis: blood cultures IV antibiotics within 1 hour withhold immunosuppression and follow the Sepsis-6 pathway
Sepsis in immunosuppressed patients: high mortality if treatment delayed. Sepsis-6: blood cultures IV antibiotics within 1 hour IV fluids oxygen lactate urine output. Withhold all immunosuppression. Immunosuppressed patients may have atypical presentations (particularly on Tocilizumab where CRP is suppressed).
Reference: BSR 2019 biologic safety; NICE NG51 Sepsis