Which patient should not begin hydrocortisone therapy?

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Hydrocortisone is a glucocorticoid used to treat various conditions, including adrenal insufficiency and inflammatory diseases. However, it is essential to consider the patient's overall health condition when initiating this therapy.

In the context of sepsis, this condition often induces a state of significant inflammation and stress. While hydrocortisone can be beneficial in managing septic shock by helping to reduce inflammation and improving hemodynamic stability, it is typically reserved for patients who do not respond adequately to fluids and vasopressors. Furthermore, initiating hydrocortisone therapy in patients with active infections like sepsis can potentially suppress the immune response. This suppression could allow infection to progress and worsen, making careful evaluation critical before starting treatment. Therefore, a patient with sepsis may not be the best candidate for beginning hydrocortisone therapy straight away without further consideration of their clinical status and possible need for immunocompromised management.

By examining this context, it becomes clear why a patient with sepsis should be approached with caution regarding starting hydrocortisone therapy.

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