Chronic Sepsis

CHRONIC SEPSIS (chroniosepsis; synonym sepsis lenta), a concept introduced by Schotmüller for certain forms of septic endocarditis that proceed slowly, progress relentlessly, and usually end fatally. Schotmüller was inclined to explain this distinctive course of septic endocarditis by the peculiarities of the virus (for details, see Endocarditis). Subsequently, observations accumulated according to which a similar clinical picture of a slowly progressing septic disease can also be observed with predominant lesions of other organs and systems. Thus, the concept of cholangitis lenta, nephritis lenta, and anaemia lenta was formed. According to researchers, what all these forms of sepsis had in common was the unity of etiology in the form of a low-virulence green streptococcus that causes the development of a prolonged septic process. Such a monological interpretation of chronic sepsis is currently disputed and has been seriously undermined by the finding of various causative agents in sepsis lenta, even of non-streptococcal nature. The mechanism of development of chronic sepsis is usually associated with the presence in the body of a prolonged inflammatory focus in the form of dental granulomas, tonsillitis, inflammations of the paranasal sinuses, etc. The frequency of these foci provided the basis for the very widespread diagnosis of chronic sepsis, which in most cases was poorly substantiated. The concept of chronic sepsis began to be used particularly widely in connection with American works on the so-called oral sepsis. Meanwhile, in most cases, the matter concerns patients with prolonged subfebrile temperature, which is essentially harmless and has a favorable course. Chronic sepsis is therefore still a vaguely defined concept that requires clarification and substantiation in each individual case.