Clinical symptoms, diagnosis and outcome of septic encephalopathy


  • Ahmed Ragab Zein Department of Intensive Care Unit, King Fahad General Hospital, Jeddah, Saudi Arabia
  • Ayat Bagi Algassab Department of Emergency Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
  • Mada Salem Almatrafi Department of Intensive Care Unit, King Abdullah Medical Complex, Jeddah, Saudi Arabia
  • Hawazen Atef Kamal Department of Neurosurgery, Al Noor Specialist Hospital, Mecca, Saudi Arabia
  • Abdulilah Mokhtar Alshenghiti Department of General Surgery, Diriyah Hospital, Riyadh, Saudi Arabia
  • Bandar Merzen Alqarni Department of Family Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
  • Ali Jaber Ashoori College of Medicine, Xi’an Jiaotong University, Xi’an, China
  • Faisal Abdulsalam Albloushi College of Medicine, Jinan University, Guangzhou, China
  • Mahmood Abdulla Alshaban College of Medicine, Xi’an Jiaotong University, Xi’an, China
  • Asma Sulaiman Alshahrani College of Medicine, King Khalid University, Abha, Saudi Arabia
  • Mohammed Emran Dawoud Primary Health Care, Ministry of Health, Kuwait City, Kuwait



Septic, Encephalopathy, Clinical, Symptoms, Outcome, Diagnosis


Septic encephalopathy (SE) is the most common complication of sepsis and a major cause of mortality and morbidity worldwide. It occurs in around two third of patients admitted with sepsis in the intensive care units. The objective of this review is to discuss clinical symptoms, diagnosis and outcomes in patients with SE. Robust research was conducted from online databases such as Google Scholar and Cochrane. Studies from the last ten years were included in our review. The pathophysiology of SE is highly dynamic where a complex sequence of events occurs as a host response to an extracranial infection. SE presents a myriad of symptoms ranging from an altered mental state with confusion, disorientation to a more severe presentation with delirium and impaired consciousness. Arriving to a diagnosis of SE requires a rigorous systemic and neurological investigation. Modalities such as neuromonitoring, neuroimaging, clinical biomarkers and mental assessment scales offer limited diagnostic value but can be utilized to co-relate clinical symptoms. It is associated with adverse outcomes such as a high rate of 28-day and 180-day mortality. The quality of life is poor in surviving patients. There is a dearth of original research on SE in the Arab region and worldwide. Major research, both as prospective and retrospective studies is essential to achieve improved management of SE. Therapeutic approaches should be tailored towards modulating pathophysiological processes of sepsis. Follow up studies based on 180 day follow ups should be used to study patient quality of life and outcomes.


Czempik PF, Pluta MP, Krzych ŁJ. Sepsis-associated brain dysfunction: a review of current literature. Int J Environmental Res Public Health. 2020;17(16):5852.

Dal-Pizzol F, Tomasi CD, Ritter C. Septic encephalopathy: does inflammation drive the brain crazy? Braz J Psychiatry. 2014;36:251-8.

Robba C, Crippa IA, Taccone FS. Septic Encephalopathy. Curr Neurol Neurosci Rep. 2018;18(12):82.

Singer M, Deutschman CS, Seymour CW. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10.

Ziaja M. Septic encephalopathy. Curr Neurol Neurosci Rep. 2013;13(10):383.

M Ringer T, Axer H, FM Romeike B. Neurological sequelae of sepsis: I) Septic encephalopathy. Open Cri Care Med J. 2011;4(1).

Zenaide PV, Gusmao-Flores D. Biomarkers in septic encephalopathy: a systematic review of clinical studies. Revista Brasileira de terapia intensiva. 2013;25:56-62.

Adam N, Kandelman S, Mantz J, Chrétien F, Sharshar T. Sepsis-induced brain dysfunction. Expert Review Anti-Infective Therapy. 2013;11(2):211-21.

Chaudhry N, Duggal AK. Sepsis associated encephalopathy. Adv Med. 2014;2014.

Zampieri FG, Park M, Machado FS, Azevedo LCP. Sepsis-associated encephalopathy: not just delirium. Clinics. 2011;66:1825-31.

Imamura Y, Hori S, Matsumoto N. Septic encephalopathy. Encephalitis Encephalomyelitis Encephalopathies. 2013;8:163-76.

Mazeraud A, Righy C, Bouchereau E, Benghanem S, Bozza FA, Sharshar T. Septic-associated encephalopathy: a comprehensive review. Neurotherapeutics. 2020;17(2):392-403.

Gofton TE, Young GB. Sepsis-associated encephalopathy. Nature Rev Neurol. 2012;8(10):557-66.

Tauber SC, Eiffert H, Brück W, Nau R. Septic encephalopathy and septic encephalitis‬‬. Expert Review Anti-infective Therapy. 2017;15(2):121-32.

Chen J, Shi X, Diao M. A retrospective study of sepsis-associated encephalopathy: epidemiology, clinical features and adverse outcomes. BMC Emergency Med. 2020;20(1):1-7.

Feng Q, Ai Y-H, Gong H. Characterization of sepsis and sepsis-associated encephalopathy. J Intensive Care Med. 2019;34(11-12):938-45.




How to Cite

Zein, A. R., Algassab, A. B., Almatrafi, M. S., Kamal, H. A., Alshenghiti, A. M., Alqarni, B. M., Ashoori, A. J., Albloushi, F. A., Alshaban, M. A., Alshahrani, A. S., & Dawoud, M. E. (2022). Clinical symptoms, diagnosis and outcome of septic encephalopathy. International Journal Of Community Medicine And Public Health, 9(2), 943–946.



Review Articles