Peculiar septic responses in traumatic tetraplegic patients

Patients with a high level tetraplegia from a spinal injury have only been able to survive the critical initial period since the development of modern resuscitation techniques including artificial respiration. However, their lives are still threatened by many complications, such as decubitis ulcers, infections and respiratory failure. We describe four young tetraplegic patients who developed an unusual sepsis pattern several years after the injury. The sepsis was accompanied by hypothermia, leukopenia and mental deterioration. This peculiar ‘silent’ sepsis may also occur in elderly people who are not paralysed. The question arises, therefore, if the chronic spinal cord injured patient may become ‘prematurely aged’.