I wonder if there will ever be a "rescue treatment" for sepsis that is based on this research. Lets hope so.
Any ED resident on their first week on the job should know how to diagnose sepsis: Temp >38°C (100.4°F) or <36°C (96.8°F), Heart rate >90, Respiratory rate >20 or PaCO₂ <32 mm Hg, WBC >12,000/mm³, <4,000/mm³, or >10% bands, Infection (suspected or present).
Double down on the blood work, take liquor, empirically give antibiotics (less and less useful, given resistances), drop temperature (paracetamol), add fluids (drops heart rate, ups blood pressure), wait for labs.
It's not hard, and I am so very sorry someone with sepsis signs was sent home. Sepsis is also a fast bastard. Meaning, from pathogen entering the blood stream to organ damage and conclusively death can be less than half an hour. That's the ones we can't catch. The guy with the ulcer, the person who injects things, the girl who didn't see a dentist about her developing abscess, the man who stopped his HIV meds... that's the ones I didn't in the past three weeks. I got them too late, or didn't see them until the ambulance unloaded a dead person.
Sepsis is a bitch. A total and utter bad player, something we drill into every resident from day one. Sometimes Mrs. Goodforall comes in with a light chest tightness and leaves on a hearse, sometimes Mr. Bluebird presents with nausea and crashes into a full on septic shock minutes later. Any one of those I can prevent, I will. I am, however, not God. Just a ED jockey with an infectious disease background. I'm probably the best hope my patients have, which isn't much, but it's something.
Bacteria growth, unchecked, is exponential. The only reason we stay a coherent organism at all in this crazy world of trillions of other organisms is that our immune system checks the hell out of bacteria growth.
... but when that's no longer possible, when the body goes from being a hostile growth environment to food... enterococcus faecalis has a doubling time of 18 minutes. One such cell, with completely-unchecked reproduction, would produce a number of itself to rival the cell-count of the entire body in only 10 hours, and it takes way less than 30 trillion enterococcus to kill a person.
I had SIRS/sepsis once and it really is a harrowing experience. It really changed me forever and as a bonus, if not to add insult to injury, my hair now falls out and barely grows. Wouldn't wish it on my worst enemy.
It's infuriating how many problems in our lives are met with a shrug.
edit: I'm a jerk, I forgot we were talking about somebody close to you. I'm sorry about your friend and I hope you're doing okay.
If you know anyone in medicine you know they are swamped by hypochondriacs, frauds and crazies. Absent clear diagnostic criteria--or a person privately funding the search costs, with time and money--it’s infeasible to expect a collectively-funded system to explore every potential case like an episode of House MD.
I had to find out about him by myself because my doctors didn't do anything other than look up my condition and give me the most common treatment option. In my case surgery usually makes things worse and is NOT advised other than as a last resort. My doctors didn't know any of this, because they didn't do their research.