Der Anaesthesist
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To date no biomarker has been identified bringing together perfect sensitivity and specificity to discriminate between inflammation and infections. Since the 1930s new markers of tissue damage and endothelial damage have been identified but which are incapable of identifying infections in every clinical setting to enable initiation of early antibiotic treatment. In this review the most important classical biomarkers and upcoming new PCR-based approaches are addressed. ⋯ The issue of discrimination between inflammation and infection is not yet solved. Based on one single biomarker it is impossible to decide whether infection is the reason for the patient's worsening condition but the combination of biomarkers or the integration of new biomarkers may be a meaningful supplement. The measurement of different biomarkers of infection or inflammation is part of the routine in critical care and will be essential in the future.
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After a resuscitation situation a SARS-CoV‑2 sample from a 55-year-old man who had been in the hospital for elective ablation for atrial fibrillation was tested positive. The patient history revealed that there had been a previous confirmed contact with a COVID-19 positive patient. ⋯ After about 2 weeks of treatment, weaning had to be stopped due to the deterioration of the severe septic condition of the patient and he showed microbiological evidence of a superinfection with Cryptococcus neoformans and later Leclercia adecarboxylata. The patient was treated successfully and survived the disease.