{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:57:04Z","timestamp":1779893824420,"version":"3.53.1"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>Sepsis is a common presentation to the emergency department (ED) with the main aim of treatment being prompt antibiotics, source identification and control, all preferably within the initial golden hour. In the majority of patients, a good history and examination is adequate to elicit the most likely source of infection and thus target therapy appropriately. However it is well known that this can be difficult in some patient groups. In this report we present two patients with sepsis with spinal cord injury (SCI) where both the history and examination were unhelpful in identifying the source of infection and demonstrate why the unique physiology and risk factors in SCI patients must be considered early in their work up. Both patients were admitted with vague, nonspecific constitutional symptoms. Both had no evidence of abdominal or flank pain or any objective tenderness. One of the patients had a long-term suprapubic catheter and one intermittently self catheterised meaning that urine dip stick results were unreliable. In both instances, the patients were found to have obstructed renal stones with associated infection and both had good outcomes after surgical intervention.<\/jats:p>","DOI":"10.1177\/14782715221148055","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T06:13:40Z","timestamp":1674800020000},"page":"40-43","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A report of two cases of sepsis in patients with spinal cord injuries"],"prefix":"10.1177","volume":"53","author":[{"given":"Jennifer","family":"Todd","sequence":"first","affiliation":[{"name":"King\u2019s College Hospital NHS Trust London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Murden","sequence":"additional","affiliation":[{"name":"Ashford and Saint Peter\u2019s Hospitals NHS Trust, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Brooks","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"key":"bibr1-14782715221148055","unstructured":"Spinal Cord Injury (SCI) Facts and Figures at a Glance 2016 SCI Data Sheet Non-Hispanic White Non-Hispanic Black Hispanic Origin,https:\/\/www.nscisc.uab.edu\/public_pages\/FactsFiguresArchives\/SCI%20Facts%20and%20Figures%20at%20a%20Glance%202016.pdf (2016, accessed 3 January 2023)."},{"key":"bibr2-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.04.021"},{"key":"bibr3-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2015.167"},{"key":"bibr4-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101053"},{"key":"bibr5-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2490-1-3"},{"key":"bibr6-14782715221148055","volume":"97","author":"Yang J-H","year":"2018","journal-title":"Medicine"},{"key":"bibr7-14782715221148055","volume":"33","author":"Bar-On Z","year":"1995","journal-title":"Paraplegia"},{"key":"bibr8-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-008548."},{"key":"bibr9-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(02)01734-X"},{"key":"bibr10-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.2001.02146.x"},{"key":"bibr11-14782715221148055","volume":"23","author":"Juler GL","year":"1985","journal-title":"Paraplegia"},{"key":"bibr12-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1089\/end.2012.0063"},{"key":"bibr13-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-014-0681-0"},{"key":"bibr14-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2006.01431.x"},{"key":"bibr15-14782715221148055","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70323-7"},{"key":"bibr16-14782715221148055","unstructured":"Quality statement 2: Diagnosing urinary tract infections in adults with catheters|Urinary tract infections in adults|Quality standards|NICE, https:\/\/www.nice.org.uk\/guidance\/qs90\/chapter\/quality-statement-2-diagnosing-urinary-tract-infections-in-adults-with-catheters (accessed 16 June 2022)."}],"container-title":["Journal of the Royal College of Physicians of Edinburgh"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14782715221148055","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14782715221148055","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14782715221148055","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:56:03Z","timestamp":1777701363000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14782715221148055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,27]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1177\/14782715221148055"],"URL":"https:\/\/doi.org\/10.1177\/14782715221148055","relation":{},"ISSN":["1478-2715","2042-8189"],"issn-type":[{"value":"1478-2715","type":"print"},{"value":"2042-8189","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,27]]}}}