Septic shock without documented infection: an uncommon entity with a high mortality.

Objectives: To determine whether patients with clinically identified infection have the same outcome as patients with apparent sepsis but no identified infectious source.

Design: Retrospective analysis of patient data.

Patients: All patients treated with septic shock in a 31-bed intensive care unit (ICU) over a 3-year period.

Results: Data from 227 patients were analysed. Eighty-seven percent had a clinically identified source of infection. ICU mortality was higher in septic shock patients without a clinically identified source of infection than in those with an identified source of infection (86% versus 66%, p < 0.05).

Conclusions: A small number of patients presenting with septic shock have no clinically identified infection. These patients have a higher mortality rate than patients in whom an infection is identified.