The Skeptics Guide to Emergency Medicine SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis
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Feb 22, 2025 Dr. Aaron Skolnick, an Assistant Professor at Mayo Clinic specializing in emergency medicine, dives into the complexities of diagnosing sepsis. He discusses the promising potential of Monocyte Distribution Width (MDW) as a rapid biomarker for early detection. Skolnick highlights the challenges of identifying sepsis due to its nonspecific symptoms and critiques existing diagnostic methodologies. The conversation also covers the biases in observational studies versus randomized control trials, and evaluates the clinical implications of MDW in emergency settings.
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Case Presentation
- A 62-year-old man presented with fever, confusion, and shortness of breath.
- He also had decreased urine output, and his examination revealed pneumonia.
Sepsis and MDW
- Diagnosing sepsis early is challenging due to nonspecific symptoms.
- Monocyte distribution width (MDW) has emerged as a potential biomarker for early sepsis detection.
Study Overview
- This systematic review and meta-analysis evaluated MDW's diagnostic accuracy for sepsis.
- The study included adults in various clinical settings, comparing MDW to sepsis 2 and 3 criteria.