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The Skeptics Guide to Emergency Medicine

SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

Feb 22, 2025
Dr. Aaron Skolnik, an Assistant Professor at Mayo Clinic and critical care expert, dives into the complexities of diagnosing sepsis. He highlights a critical case of a 62-year-old man with severe symptoms and discusses the limitations of current biomarkers. The conversation centers on monocyte distribution width (MDW) as a promising but not yet routine diagnostic tool for sepsis in emergency settings. Skolnik also examines biases in sepsis studies, underscoring the importance of clinician judgment in making accurate diagnoses.
22:14

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Quick takeaways

  • Timely identification of sepsis is crucial as early treatment significantly decreases patient mortality rates despite challenges from vague symptoms.
  • Monocyte distribution width (MDW) shows potential for enhancing early sepsis detection but should not yet replace traditional diagnostic methods.

Deep dives

Importance of Rapid Sepsis Diagnosis

Timely identification of sepsis is vital, as early treatment can significantly lower patient mortality rates. Patients often present with vague, nonspecific symptoms, making quick diagnosis challenging. Traditional biomarkers like procalcitonin and lactate have some utility, but they are not reliable enough when used in isolation to confirm sepsis. Monocyte distribution width (MDW) has recently emerged as a potential diagnostic tool that can be quickly determined during a complete blood count, offering an advantage in fast-paced emergency department environments.

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