{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:45:57Z","timestamp":1792215957744,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":287,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020050","name":"Japan Intractable Diseases Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sepsis mimics are non\u2010infectious conditions that resemble sepsis, leading to diagnostic uncertainty, delayed disease\u2010specific therapy, and unnecessary antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted semi\u2010structured online interviews with seven physicians with experience in adult general intensive care unit (ICU) practice in Japan (October\u2013December 2023) and analyzed data using Reflexive Thematic Analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four themes were generated: (1) Spectrum\u2014participants described sepsis mimics as spanning hematologic malignancy, autoimmune\/inflammatory disease, endocrine\/metabolic crises, drug\/toxic states, and other acute non\u2010infectious conditions. (2) Diagnostic challenges\u2014participants described phenotypic overlap, missing or fragmented history, organizational barriers to definitive testing in unstable patients, competing pathophysiology, and diagnostic masking by early corticosteroids. (3) Therapeutic and diagnostic strategies\u2014participants described a sepsis\u2010oriented initial approach with broad antibiotics and organ support, followed by reactive re\u2010evaluation for nonresponse or early parallel work\u2010up for selected mimics. (4) Triggers for re\u2010evaluation\u2014participants described reconsidering sepsis when the clinical course or physiology diverged from expectations, including discrepant hemodynamics, atypical fever patterns, focal physical signs, and metabolic abnormalities not readily explained by presumed infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sepsis mimics were described as diagnostically challenging in ICU practice because clinical trajectories can initially resemble sepsis and because diagnostic work\u2010up is shaped by local organizational constraints. By mapping clinicians' reasoning processes and re\u2010evaluation cues, our findings provide a framework for understanding diagnostic uncertainty and may inform educational efforts and future research on timely recognition of sepsis mimics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ams2.70171","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:56:56Z","timestamp":1792119416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sepsis Mimics in the\n                    <scp>ICU<\/scp>\n                    : A Qualitative Study of Physicians' Diagnostic Experiences in Japan"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-3003","authenticated-orcid":false,"given":"Daisuke","family":"Kasugai","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"},{"name":"Institute of Nano\u2010Life\u2010Systems, Institutes of Innovation for Future Society Nagoya University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Higashi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2182-3108","authenticated-orcid":false,"given":"Kasumi","family":"Satoh","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1606-7037","authenticated-orcid":false,"given":"Hiroaki","family":"Hiraiwa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naruhiro","family":"Jingushi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"},{"name":"Department of Emergency and General Internal Medicine Fujita Health University School of Medicine  Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1072-7089","authenticated-orcid":false,"given":"Yutaka","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Disaster Medicine Juntendo University Graduate School of Medicine  Tokyo 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