Sepsis

Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when your body has an overwhelming immune response to a bacterial infection and chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can lead to blood clots and damaged blood vessels, which causes poor blood flow. The organs are deprived of nutrients and oxygen, which can cause damage multiple organ systems and cause them to fail.

Common symptoms of sepsis are fever, chills, rapid breathing and heart rate, rash, confusion, and disorientation.

If sepsis progresses to septic shock, blood pressure drops dramatically and the heart weakens, which may lead to death.

Sepsis is most common and most dangerous in older adults and those with weakened immune systems. Early treatment of sepsis usually involves antibiotics and large amounts of intravenous fluids.

Sepsis can be viewed as a three-stage syndrome, starting with sepsis and progressing through severe sepsis to septic shock.

Sepsis is characterized by the following symptoms:

• body temperature above 101º F (38.3º C) or below 96.8º F (36º C)
• heart rate higher than 90 beats a minute
• respiratory rate higher than 20 breaths a minute
• probable or confirmed infection

Severe sepsis includes at least one of the following signs and symptoms, which indicate an organ may be failing:

• significantly decreased urine output
• abrupt change in mental status
• decrease in platelet count
• difficulty breathing
• abnormal heart pumping function
• abdominal pain

Septic shock is characterized by the signs and symptoms of severe sepsis plus extremely low blood pressure that does not adequately respond to treatment.

Any type of infection (bacterial, viral, or fungal) can lead to sepsis, but the most likely varieties include:

• pneumonia
• abdominal infection
• kidney infection
• bloodstream infection (bacteremia)

Sepsis is more common and more dangerous if you:

• are very young or very old
• have a compromised immune system
• are already very sick, often in a hospital's intensive care unit
• have wounds or injuries, such as burns or physical trauma
• have invasive devices, such as intravenous catheters or breathing tubes
• have a chronic illnesses, such as diabetes, AIDS, cancer, and kidney, or liver disease

Doctors diagnose sepsis using a blood test to see if the number of white blood cells is abnormal. They also do lab tests that check for signs of infection. Diagnosing sepsis can be difficult because its signs and symptoms can be caused by other disorders. Doctors often order a battery of tests, including imaging scans and tests of blood or other bodily fluids, to try to pinpoint the underlying infection.

People with sepsis are usually treated in hospital intensive care units. Doctors try to treat the infection, prevent damage to the vital organs, and maintain healthy blood pressure. Many patients receive oxygen and intravenous fluids during treatment. Other types of treatment, such as respirators or kidney dialysis, may be necessary.

The goal of treatment of sepsis is to eliminate the infection and prevent damage to organ systems. Ideally, sepsis is treated during its mild stage, before it becomes more dangerous.

A number of medications are used in treating sepsis, including:

• antibiotics. Treatment with intravenous antibiotics begins immediately upon diagnosis with sepsis.
• vasopressors. If your blood pressure remains low even after receiving intravenous fluids, you may be given a vasopressor medication, which helps to increase blood pressure.

Other medications that are used to treat sepsis include low doses of corticosteroids, insulin to help maintain stable blood sugar levels, drugs that modify the immune system responses, and painkillers or sedatives.

Surgery may be needed to remove sources of infection, such as collections of pus (abscesses).